Mobility & Flexibility - Joint Movement

Individuals in post-surgery recovery or dealing with illness or an injury can experience weakened muscles and endurance that can cause temporary loss of sleeping mobility and inability to move around normally because of weakness, decreased range of motion, or pain. Can they benefit from physical therapy to help get back to normal functional mobility?

Sleeping Mobility

For individuals who are hospitalized or homebound from injury, illness, or surgical recovery, a physical therapist will assess various areas of functional mobility. These include transfers - from sitting to standing positions, walking, and sleeping mobility. Sleeping mobility is the ability to perform specific motions while in bed. A therapist can assess sleeping or bed mobility and recommend strategies and exercises to improve movements. (O'Sullivan, S. B., Schmitz, T. J. 2016) A therapist may have the individual use specific devices, like an over-the-bed trapeze or a sliding board, to help move around.

Bed and Sleeping Mobility

When a physical therapist checks mobility, they will assess various motions that include: (O'Sullivan, S. B., Schmitz, T. J. 2016)

• Moving from sitting to lying down.
• Moving from lying down to sitting up.
• Rolling over.
• Scooting or sliding up or down.
• Scooting or sliding sideways.
• Twisting.
• Reaching.
• Raising the hips.

All of these movements require strength in different muscle groups. By checking out individual motions in sleeping mobility, a therapist can work out specific muscle groups that may be weak and require targeted exercises and stretches to restore mobility to normal. (O'Sullivan, S. B., Schmitz, T. J. 2016) Individuals visiting a therapist in an outpatient clinic or rehabilitation area may have the individual work on sleeping mobility on a treatment table. The same motions on the treatment table can be done in the bed.

Importance

The body is meant to move. For individuals who cannot move comfortably on their bed, the body may suffer disuse atrophy or the wasting away of muscular strength, which can lead to increased difficulties. Not being able to move can also lead to pressure ulcers, especially for individuals who are severely deconditioned and/or remain in one position for a long period. Skin health may start to break down, leading to painful wounds that require specialized care. Being able to move around in bed can help prevent pressure ulcers. (Surajit Bhattacharya, R. K. Mishra. 2015)

Improvement

A physical therapist can prescribe specific exercises to strengthen muscle groups and improve sleeping mobility.  The muscles include:

• Shoulder and rotator cuff muscles.
• Triceps and biceps in the arms.
• Gluteus muscles of the hips.
• Hamstrings
• Quadriceps
• Calf muscles

The shoulders, arms, hips, and legs work together when moving the body around the bed.

Various Exercises

To improve bed movement, physical therapy exercises can include:

• Upper extremity exercises
• Lower trunk rotation
• Glute exercises
• Bridges
• Leg raises
• Short arc quads
• Ankle pumps

Physical therapists are trained to assess these motions and functions and prescribe treatments to improve body movement. (O'Sullivan, S. B., Schmitz, T. J. 2016) Maintaining appropriate physical fitness can help the body stay active and mobile. Performing mobility exercises prescribed by a physical therapist can keep the right muscle groups working properly, and working with a physical therapist can ensure the exercises are correct for the condition and are performed properly.

Optimizing Your Wellness

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

O'Sullivan, S. B., Schmitz, T. J. (2016). Improving Functional Outcomes in Physical Rehabilitation. United States: F.A. Davis Company.

Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 48(1), 4–16. https://doi.org/10.4103/0970-0358.155260

Individuals with plantar fasciitis may experience consistent flare-ups. Can knowing the causes help to find pain relief?

Plantar Fasciitis Flare-Up

Plantar fasciitis is a common cause of heel and foot pain. The plantar fascia is a band of tissue that runs along the bottom of the foot and becomes inflamed. Certain factors can cause plantar fasciitis flare-ups, including:

• Increased levels of physical activity. 
• Not stretching regularly.
• Wearing shoes without proper support.
• Weight gain.

Causes

A plantar fasciitis flare-up is often triggered by physical activity. (MedlinePlus. U.S. National Library of Medicine. 2022) It can also be brought on by underlying conditions, like increased body weight, arthritis, or the shape of the foot. (Johns Hopkins Medicine. 2023) Despite the root cause, there are activities and experiences that can contribute to and/or worsen the condition.

New Exercise Routine

• Being highly physically active can exacerbate plantar fasciitis symptoms.
• A plantar fasciitis flare-up can happen after a sudden increase in activity, like starting a new exercise program or adding new exercises to a routine. (MedlinePlus. U.S. National Library of Medicine. 2022)
• Walking or running on uneven surfaces or downhill can be a trigger. (Johns Hopkins Medicine. 2023)
• Minimizing physical activity and time standing can help.
• If this is not possible, wearing cushioned shoes with arch support can help minimize pain. (Johns Hopkins Medicine. 2023)

Weight Gain

• Individuals who have an increased or increasing body weight add more pressure to their feet, placing them at higher risk for plantar fasciitis. (MedlinePlus. U.S. National Library of Medicine. 2022)
• If experiencing consistent flare-ups, a healthcare provider may suggest an appropriate weight loss program combined with a treatment plan.

Pregnancy

• Rapid weight gain can cause a plantar fasciitis flare-up, including during pregnancy. (Boston Children's Hospital. 2023)

Shoes Without Support

• Wearing shoes without arch support can cause general foot pain and plantar flare-ups.
• Individuals should wear shoes with plenty of cushioning and arch support, like sneakers. (Ortho Info. Academy of Orthopaedic Surgeons. 2022)
• Shoes that are not recommended include:
• Flip-flops
• Shoes that are flat.
• High heels, boots, or shoes that raise the heel above the toes.
• Worn-out shoes like exercise workout shoes.

Not Stretching Properly or At All

• Tight calves can increase pressure on the plantar fascia.
• Stretching the calves, Achilles tendon/heel, and the bottom of the feet is highly recommended to help treat and prevent the condition. (Johns Hopkins Medicine. 2023)
• Not stretching thoroughly or skipping stretches can worsen symptoms.
• Individuals with plantar fasciitis are recommended to stretch before and after physical activities, exercise, before going to bed, and after waking up.

Working Through the Pain

• Individuals may try to continue physical activities during a flare-up.
• This is not recommended as doing so can cause more pain and worsen the condition.
• When pain presents, it’s recommended to:
• Stop all activities that strain the feet
• Stay off the feet for at least a week.

Tearing the Plantar Fascia

• The plantar fascia rarely tear completely from repeated stress known as a plantar fascia rupture.
• If this happens, sudden severe pain will present and individuals are advised to call their healthcare provider. (Stephanie C. Pascoe, Timothy J. Mazzola. 2016)
• However, individuals can recover relatively fast, and pain alleviates quickly.
• Individuals with tears will be recommended to wear a foot orthotic as the foot may have flattened more.

Risk Factors

Plantar fasciitis can happen to anyone, but individuals who have the following characteristics are at an increased risk: (Ortho Info. Academy of Orthopaedic Surgeons. 2022)

• A high-foot arch.
• Jobs or hobbies that place added strain on the feet.
• Tight calf muscles.
• A sudden increase in physical activity.
• A new exercise regimen.
• Increased body weight.
• Sudden weight gain like during pregnancy.

How Long Does a Flare Last?

• Plantar fasciitis can become chronic if untreated.
• With treatment, 90% of cases will improve within 10 months. (Ortho Info. Academy of Orthopaedic Surgeons. 2022)
• During a flare-up, stay off the feet as much as possible.

Treatment

 In addition to rest treatments for plantar fasciitis can include: (Ortho Info. Academy of Orthopaedic Surgeons. 2022)

Ice

• Icing the bottom of the foot for 15 minutes a few times a day decreases inflammation.

Nonsteroidal anti-inflammatory drugs - NSAIDs

• Over-the-counter NSAIDs like ibuprofen and naproxen, can reduce pain and inflammation.
• It is recommended to consult a healthcare provider for short-term use and dosage.

Proper Shoes

• Shoes with arch supports are highly recommended.
• A healthcare provider can order custom orthotics for more support.

Stretching

• Stretches are essential for treatment.
• Stretching the calf and bottom of the foot daily will keep the tissue relaxed.

Massages

• Massaging the area with a therapeutic massage ball soothes the tissues.
• Using a percussive massager can increase circulation.

What is Plantar Fasciitis?

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

MedlinePlus. National Library of Medicine.  (2022) U.S. Plantar fasciitis.

Johns Hopkins Medicine. (2023) Plantar fasciitis.

Boston Children's Hospital. (2023) Plantar fasciitis.

Ortho Info. Academy of Orthopaedic Surgeons. (2022) Plantar fasciitis and bone spurs.

Pascoe, S. C., & Mazzola, T. J. (2016). Acute Medial Plantar Fascia Tear. The Journal of orthopaedic and sports physical therapy, 46(6), 495. https://doi.org/10.2519/jospt.2016.0409

For individuals with a broken collarbone, can conservative treatment help in the rehabilitation process?

Broken Collarbone

Broken collarbones are very common orthopedic injuries that can occur in any age group. Also known as the clavicle, it is the bone over the top of the chest, between the breastbone/sternum and the shoulder blade/scapula. The clavicle can be easily seen because only skin covers a large part of the bone. Clavicle fractures are extremely common, and account for 2% - 5% of all fractures. (Radiopaedia. 2023) Broken collarbones occur in:

• Babies - usually during birth.
• Children and adolescents - because the clavicle does not fully develop until the late teens.
• Athletes - because of the risks of being hit or falling.
• Through various types of accidents and falls.
• The majority of broken collarbones can be treated with nonsurgical treatments, usually, with a sling to let the bone heal and physical therapy and rehabilitation.
• Sometimes, when clavicle fractures are significantly shifted out of alignment, surgical treatment may be recommended.
• There are treatment options that should be discussed with an orthopedic surgeon, physical therapist, and/or a chiropractor.
• A broken collarbone is not more serious than other broken bones.
• Once the broken bone heals, most individuals have a full range of motion and can return to the activities before the fracture. (Johns Hopkins Medicine. 2023)

Types

Broken clavicle injuries are separated into three types depending on the location of the fracture. (Radiopaedia. 2023)

Mid-Shaft Clavicle Fractures

• These occur in the central area which can be a simple crack, separation, and/or fractured into many pieces.
• Multiple breaks - segmental fractures.
• Significant displacement - separation.
• Shortened length of the bone.

Distal Clavicle Fractures

• These happen close to the end of the collarbone at the shoulder joint.
• This part of the shoulder is called the acromioclavicular/AC joint.
• Distal clavicle fractures can have similar treatment options as an AC joint injury.

Medial Clavicle Fractures

• These are less common and often related to injury to the sternoclavicular joint.
• The sternoclavicular joint supports the shoulder and is the only joint that connects the arm to the body.
• Growth plate fractures of the clavicle can be seen into the late teens and early 20s.

Symptoms

Common symptoms of a broken collarbone include: (National Library of Medicine: MedlinePlus. 2022)

• Pain over the collarbone.
• Shoulder pain.
• Difficulty moving the arm.
• Difficulty raising the arm from the side.
• Swelling and bruising around the shoulder.
• The bruising can extend down to the chest and armpit.
• Numbness and tingling down the arm.
• Deformity of the collarbone.

1. In addition to the swelling, some individuals may have a bump in the place where the fracture occurred.
2. It can take several months for this bump to fully heal, but this is normal.
3. If the bump appears inflamed or irritated, inform a healthcare provider.

Clavicular Swelling

• When the sternoclavicular joint swells up or gets bigger, it is referred to as clavicular swelling.
• It is commonly caused by trauma, disease, or an infection that affects the fluid found in the joints. (John Edwin, et al., 2018)

Diagnosis

• At the healthcare clinic or emergency room, an X-ray will be obtained to assess for the specific type of fracture.
• They will perform an examination to ensure the nerves and blood vessels surrounding the broken collarbone are unsevered.
• The nerves and vessels are rarely injured, but in severe cases, these injuries can occur.

Treatment

Treatment is accomplished either by allowing the bone to heal or by surgical procedures to restore the proper alignment. Some common treatments for broken bones are not used for clavicle fractures.

• For example, casting a broken collarbone is not done.
• In addition, resetting the bone or a closed reduction is not done because there is no way to hold the broken bone in proper alignment without surgery.

If surgery is an option the healthcare provider looks at the following factors: (UpToDate. 2023)

Location of Fracture and Degree of Displacement

• Nondisplaced or minimally displaced fractures are usually managed without surgery.

Age

• Younger individuals have an increased ability to recover from fractures without surgery.

Shortening of the Fracture Fragment

• Displaced fractures can heal, but when there is a pronounced shortening of the collarbone, surgery is probably necessary.

Other Injuries

• Individuals with head injuries or multiple fractures can be treated without surgery.

Patient Expectations

• When the injury involves an athlete, heavy job occupation, or the arm is the dominant extremity, there can be more reason for surgery.

Dominant Arm

• When fractures occur in the dominant arm, the effects are more likely to be noticeable.

The majority of these fractures can be managed without surgery, but there are situations where surgery can produce better results.

Supports for Non-surgical Treatment

• A sling or figure-8 clavicle brace.
• The figure-8 brace has not been shown to affect fracture alignment, and many individuals generally find a sling more comfortable. (UpToDate. 2023)

1. Broken collarbones should heal within 6–12 weeks in adults
2. 3–6 weeks in children
3. Younger patients are usually back to full activities before 12 weeks.
4. The pain usually subsides within a few weeks. (4
5. Immobilization is rarely needed beyond a few weeks, and with a doctor's clearance light activity and gentle motion rehabilitation usually begins.

Long-Lasting Injuries

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 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 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

Radiopaedia. Clavicular fracture.

Johns Hopkins Medicine. Clavicle fractures.

National Library of Medicine: MedlinePlus. Broken collarbone - aftercare.

UpToDate. Clavicle fractures.

Edwin, J., Ahmed, S., Verma, S., Tytherleigh-Strong, G., Karuppaiah, K., & Sinha, J. (2018). Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies. EFORT open reviews, 3(8), 471–484. https://doi.org/10.1302/2058-5241.3.170078

Individuals at work, school, etc, perform all kinds of repetitive physical tasks that put their bodies through a great deal of musculoskeletal stress, what are the effects and benefits of joint manipulation therapy for pain relief?

Joint Manipulation Health Benefits

Joint manipulation is a form of manual therapy that involves applying force to the spinal or peripheral joints to:

• Relieve pain symptoms.
• Realign the joints to their proper position.
• Restore flexibility.
• Improve mobility.
• Increase range of motion.

Chiropractors, massage, and physical therapists use various manipulation techniques to help move and feel better after an injury or illness that causes loss of functional mobility. Here we explain joint manipulation, its applications, and if the technique is safe for you and your condition.

Joint Popping

• The joints in the body are places where two or more bones come together to allow movement.
• On the ends of a bone is a lining of hyaline cartilage.
• The cartilage allows the joint surfaces to glide/slide smoothly.
• If the cartilage is injured or damaged, pain and limited motion can present.
• When a joint doesn't move properly, the muscles surrounding that joint don't contract properly.
• If a joint is dysfunctional for some time, significant muscle wasting and atrophy can occur around the joint, leading to difficulty with mobility like standing, walking, or reaching. (Hurley MV.1997)

The body is made up of cells that breathe by converting energy and releasing waste materials. One type of waste material from cell respiration is carbon dioxide. The gas is transported through the blood and delivered out of the body while breathing. Small pockets of gas can get trapped in the joints that expand and contract as pressure around the joint changes during movement, known as cavitation. When the gas is released through joint manipulation, there can be a popping or snapping sound as the joint is moved. Once the gas is released, joint pressure is decreased and mobility is increased. (Kawchuk, et al., 2015)

Causes

Non-medical

There are non-medical and medical causes of joint dysfunction and derangement that include:

• Overuse and repetitive strain.
• Unhealthy sitting and/or standing posture.
• Lack of physical activity.
• Over-stretching or stretching incorrectly.

In these situations, the joints can be temporarily placed in a dysfunctional/compromised position. When moving to the correct position, a popping sound can present as built-up pressure is released.

Medical

Joint problems can occur from medical conditions that can include:

• Herniated cervical or lumbar discs.
• Spinal arthritis.
• Rheumatoid arthritis.
• Osteoarthritis.
• Joint contracture after being immobilized for some time.

In these cases, a medical problem can be causing a limitation in the joint's position and movement. (Gessl, et al., 20220)

Benefits

If a chiropractic practitioner determines there is joint dysfunction then manipulation may be a treatment option. The benefits include:

Pain Relief

• When a chiropractor or therapist gets an injured joint moving properly, the receptors in and around the area get reset allowing for pain relief.

Improved Muscle Activation

• As a chiropractor manipulates a joint into its correct anatomical position, the surrounding muscles can flex and contract properly.

Improved Range of Motion

• The joint is repositioned for proper movement.
• This improves the range of motion and relieves tightness and stiffness.

Improved Functional Mobility

• Once a joint is manipulated, the improved range of motion and muscle activation around the joint can lead to improved overall functional mobility. (Puentedura, et al., 2012)

Candidates

Joint manipulation is a safe manual therapy technique for certain individuals. (Puentedura, et al., 2016) This includes:

• Individuals with acute neck, back, or peripheral joint pain.
• Adults aged 25 to 65 with no serious medical conditions.
• Athletes who have been injured from their sport.
• Individuals who have been immobilized after injury or surgery. 

Joint manipulation is not recommended for everyone and can be dangerous or lead to injury in individuals with certain conditions. (Puentedura, et al., 2016) These include individuals with:

Osteoporosis

• Weakened bones may fracture if a high-velocity force is applied to a joint via manipulation

Joint fractures

• Individuals with a joint fracture, should not have that specific joint manipulated.

Post Spinal Fusion Surgery

• Individuals that have had spinal fusion in the neck or lower back should avoid spinal joint manipulations or adjustments for at least one year after the procedure.
• The bones need time to heal thoroughly.
• Manipulation can cause a failure of the fusion.

Individuals with Arterial Insufficiency In Their Neck

• A rare but dangerous side effect of a neck adjustment is the risk of tearing an artery in the neck known as the vertebrobasilar artery. (Moser, et al., 2019)

If there is pain, loss of movement, or decreased mobility after an injury or surgery, a chiropractic adjustment with joint manipulation can be beneficial to help regain movement. Manual techniques can help improve joint mobility, alleviate pain, and increase strength and stability around the joints. Joint manipulation isn't for everyone and is recommended to consult with a healthcare professional to see if it is safe for your specific condition.

Arthritis Explained

General Disclaimer *

Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment, and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Annals of the rheumatic diseases, 80(7), 884–890. https://doi.org/10.1136/annrheumdis-2020-218744

Hurley M. V. (1997). The effects of joint damage on muscle function, proprioception, and rehabilitation. Manual therapy, 2(1), 11–17. https://doi.org/10.1054/math.1997.0281

Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470

Moser, N., Mior, S., Noseworthy, M., Côté, P., Wells, G., Behr, M., & Triano, J. (2019). Effect of cervical manipulation on the vertebral artery and cerebral hemodynamics in patients with chronic neck pain: a crossover randomized controlled trial. BMJ open, 9(5), e025219. https://doi.org/10.1136/bmjopen-2018-025219

Puentedura, E. J., Cleland, J. A., Landers, M. R., Mintken, P. E., Louw, A., & Fernández-de-Las-Peñas, C. (2012). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from thrust joint manipulation to the cervical spine. The Journal of orthopedic and sports physical therapy, 42(7), 577–592. https://doi.org/10.2519/jospt.2012.4243

Puentedura, E. J., Slaughter, R., Reilly, S., Ventura, E., & Young, D. (2017). Thrust joint manipulation utilization by U.S. physical therapists. The Journal of manual & manipulative therapy, 25(2), 74–82. https://doi.org/10.1080/10669817.2016.1187902

Joints are the musculoskeletal areas where two bones connect. The joints have soft tissues around them, like cartilage, tendons, and ligaments. Cartilage is the flexible tissue that covers the ends of the bones at a joint. The tendons are bands between the muscles and bones that connect everything to initiate joint movement. And the ligaments are a kind of bridge that connects the bones of the joints to keep the body stable when in motion. After an injury, the joints need to be worked out, stretched, and massaged to return to proper function and support. A chiropractic personalized rehabilitation program will include exercises that target joint stability.

Joint Injury Rehabilitation

The shoulders, elbows, wrists, knuckles, hips, knees, and ankles are joints. The spine is also made up of joints. The first step for achieving joint stability after a lower-body injury is to assess the joints for:

• Local strength
• Control
• Structural defects

A physician, chiropractor, or therapist will check the joint and test for weakness or deficits in soft tissues, tendons, ligaments, and cartilage.

• Individuals can have conditions, diseases, or injuries that affect the joints, causing dysfunction.
• Correcting deficits may require taping, bracing, exercises, or surgery.
• Joint stability is attained through specific exercises that target balance, proprioception, range of motion, flexibility, strength, and endurance.
• Individuals must participate in their rehabilitation program to fully recover from their injuries.

Proprioception and Neuromuscular Training 

Neuromuscular training and proprioception are essential to joint stability.

• Neuromuscular control is an unconscious response to joint motions without awareness.
• It is how workers or athletes adjust to uneven pavement or shift their weight to stay balanced on an incline or stairs.
• Proprioception is the ability to sense the body's orientation in the environment.
• It allows body movement and responds without consciously thinking about where the body is in space.
• The information signals detect joint position, limb movement, direction, and speed.
• A joint with a high level of neuromuscular control and a trained proprioceptive system can respond appropriately to various forces placed upon it during activity, decreasing the risk of injury.
• Proprioceptive exercises train joint proprioceptors to adapt before initiating a potentially damaging/injurious movement.

Targeted Training

• Specific to the individual's injury, specific exercises are incorporated to regain/relearn skill sets and reset automatic movement patterns.
• Skills training improves the ability to make adjustments quickly and decreases the potential for worsening or creating another injury.
• Research has found that individuals who participate in neuromuscular retraining have improved muscular activation and reaction to changes compared to those who do not incorporate retraining exercises.
• Trainers and therapists use neuromuscular exercises to prevent and rehabilitate ACL injuries.

Lower Extremities Rehabilitation Exercises Therapy

The following example of an exercise rehabilitation program can be used to rehabilitate the lower extremities. The exercises should be done slowly over several weeks. Therapeutic exercises should be combined with an appropriate and gradual range of motion and strengthening program. Individuals should always work with a chiropractor and physical therapist to develop the most suitable program for specific injuries and limitations.

One-Leg Balance

• Try to stand on one leg for 10 to 30 seconds.

One-Leg Balance with Eyes Closed

•  Stand on one leg for 10 to 30 seconds with your eyes closed.

Balance Board with Half-Squats

• Balance on a wobble board. 
• Perform ten slow, controlled half-squats.

Step-Ups

• Step up onto a balance board.
• Place a balance board, soft pillow, or foam pad 6 to 8 inches above the starting point.
• Step up ten times.

Step Downs

• Step down onto the balance board.
• Place a balance board, soft pillow, or foam pad 6 to 8 inches lower than the starting point.
• Step down ten times.

Single-Leg Hops

• Hop forward and focus on landing properly.

Single-Leg Spot Jumps

• Hop from one spot to another spot on the floor.

Transform Your Body

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 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, don't hesitate to 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

Akbar, Saddam, et al. "Effects of neuromuscular training on athletes' physical fitness in sports: A systematic review." Frontiers in physiology vol. 13 939042. 23 Sep. 2022, doi:10.3389/fphys.2022.939042

Borrelli, Joseph Jr et al. "Understanding Articular Cartilage Injury and Potential Treatments." Journal of orthopedic trauma vol. 33 Suppl 6 (2019): S6-S12. doi:10.1097/BOT.0000000000001472

Cote, Mark P, et al. "Rehabilitation of acromioclavicular joint separations: operative and nonoperative considerations." Clinics in sports medicine vol. 29,2 (2010): 213-28, vii. doi:10.1016/j.csm.2009.12.002

Jeong, Jiyoung, et al. "Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury." The American Journal of sports medicine vol. 49,1 (2021): 183-192. doi:10.1177/0363546520972990

Porschke, Felix, et al. "Return to work after acromioclavicular joint stabilization: a retrospective case-control study." Journal of orthopedic surgery and Research vol. 14,1 45. 12 Feb. 2019, doi:10.1186/s13018-019-1071-7

Vařeka, I, and R Vařeková. “Kontinuální pasivní pohyb v rehabilitaci kloubů po úrazech a operacích” [Continuous passive motion in joint rehabilitation after injury and surgery]. Acta Chirurgie orthopaedicae et traumatologiae Cechoslovaca vol. 82,3 (2015): 186-91.

Introduction

The hips play a crucial role in maintaining stability and mobility in the body. However, incorrect actions can lead to misalignment and pain in the hip muscles, causing discomfort and affecting other muscles and joints. This article focuses on the hip flexor muscles and how assessing them with MET therapy can reduce pain and restore hip mobility. We utilize and incorporate valuable information about our patients to certified medical providers using MET therapy to relieve chronic muscle pain associated with the hip flexor muscles. We encourage and refer patients to associated medical providers based on their findings while supporting that education is a remarkable and fantastic way to ask our providers the essential questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., comprises this information as an educational service. Disclaimer

What Are The Hip Flexor Muscles?

Do you have any pain in your hips? Does shifting your weight from one side to the other help relieve the pain? Do you feel pain shooting down from your hips to your legs? These symptoms may be due to pain in your hip flexor muscles. Research studies reveal that these muscles support other muscle groups like the trunk and legs, allowing for proper muscle activity when lifting your legs straight during functional tests for the hips and pelvis. The hip flexors in your hips consist of six muscles that aid in stability and mobility:

• Psoas Major
• Iliacus
• Rectus Femoris
• Sartorius
• Adductor Longus
• Tensor Fasciae Latae

Additional studies have revealed that the hip flexor muscles are crucial in supporting the lower back and maintaining stability. These six muscles aid in hip movements such as deep flexion, adduction, and external rotation, among other functions. The relationship between the hip flexors and the lumbar spine is particularly strong. However, if these muscles become tight, it can negatively affect performance and lead to other issues.

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*

Introduction

When it comes to our muscles, many of us often don’t stretch each muscle group at least two to three times per week. From waking up in the morning, we stretch our arms, legs, and back to relieve any stiffness or soreness from the previous day. However, many individuals deal with musculoskeletal issues that can affect not only the back and the neck but also the upper and lower extremities of the body, causing pain-like symptoms that can worsen throughout the entire day if not treated right away. When this happens, musculoskeletal pain can lead to overlapping risk problems that can cause the body to be misaligned and dysfunctional. Hence why numerous therapies help reduce the effects of musculoskeletal pain and help restore the body naturally. Today’s article looks at how musculoskeletal pain affects the body and how treatments like MET can be used as self-help methods to reduce musculoskeletal pain. We utilize valuable information about our patients to certified medical providers using MET therapy to relieve musculoskeletal pain by incorporating various exercises and stretches. We encourage and refer patients to associated medical providers based on their diagnosis while supporting that education is a remarkable and fantastic way to ask our providers the essential questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., comprises this information as an educational service. Disclaimer

Musculoskeletal Pain Affecting The Body

Are you experiencing muscle stiffness or weakness in your back, neck, or shoulders? Do you feel pain when stretching or hunched over due to discomfort? Musculoskeletal pain is a common issue that can interfere with daily activities. Research studies show that this type of pain can cause symptoms that overlap with neuropathic or visceral pain. This means that problems with one muscle or organ in the body can lead to pain in other areas, causing significant discomfort.

Further research has shown that musculoskeletal pain can originate in the muscle tissues and persist for over three months, affecting many individuals’ social and emotional skills, work productivity, and independence. Several environmental factors like obesity, stress, poor sleep, inadequate nutrition, and lack of physical activity can overwork the muscles and joints, leading to trigger points and muscle strain in the musculoskeletal system, resulting in bodily misalignment.

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*

Everyone experiences a muscle cramp at some point. A muscle cramp is an involuntarily contracted muscle that does not relax, similar to a spasm, but a cramp lasts longer and is usually a forcible contraction. During a cramp, the muscles tighten without voluntary input from the brain and over-tighten. They can last anywhere from a few seconds to an hour or longer. They can be prevented through adequate nutrition and hydration, attention to safety when engaged in physical activity or exercise, and attention to posture and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic can develop personalized treatment plans for individuals experiencing musculoskeletal issues.

Muscle Cramp

Muscle cramps can occur in any muscle. The cramp may involve a portion of a muscle, the entire muscle, or several muscles that function together. A muscle or a few tissue fibers that involuntarily contracts is in a spasm. If the spasm is forcefully sustained, it turns into a cramp. They can cause a noticeable and/or hardening of the involved muscle/s. They can be experienced as mild twitches or can be excruciatingly painful. Some can involve the simultaneous contraction of muscles that normally move body parts in opposite directions. It is not uncommon for a cramp to flare up multiple times until it finally stops. 

Causes

They can occur during physical activity, exercise, rest, or night, depending on the cause. There are various causes that, include:

• Dehydration.
• Electrolyte imbalance.
• General overexertion.
• Physical exertion in hot weather.
• Physical deconditioning.
• Medications and supplements.

Most times, they are not a cause for alarm; however, depending on the individual, their age, type of physical activity, and medical history, cramps could indicate a more serious underlying problem such as a thyroid disorder, liver cirrhosis, atherosclerosis, ALS, or a problem or condition of the spine or spinal nerves.

Muscles Involved

The muscles involved can indicate the mechanism and cause.

• If the cramp is triggered by fatigue, a drop in muscle glycogen, dehydration, or an electrolyte imbalance, it's most frequently to the calf muscles, feet, or back of the thigh/hamstring muscles.
• This is typically due to a combination of fatigue and dehydration.
• If it is triggered by nerve irritation, like a spinal disc injury, cramps tend to present in the forearm, hand, calf, and foot, depending on whether the disc injury is in the neck or lower back.
• If there is a joint sprain in the neck, mid-back, or lower back, the cramp will present where the injury is and around the surrounding muscles.
• A calf cramp happens when lying down because the foot points down, shortening the calf muscles.
• A shortened muscle is more likely to go into spasm, especially if it is exhausted from activities and if the body is dehydrated, which is pretty common.
• For two muscles that work together performing the same movement, called agonists, and the one muscle is weaker, the secondary muscle has to work harder, often going into a spasm or cramp from the added stress.
• For example, if the buttock/gluteal muscles are weak, the hamstrings eventually spasm when exhausted.

Chiropractic

First, the cause needs to be identified through medical history and examination. There can be an underlying nerve irritation and interference, restricting the muscle or muscle group, which needs to be dealt with for the therapy to be effective. Chiropractic care, combined with therapeutic stretching and massage therapy, can:

• Relieve muscle cramping
• Improve blood circulation
• Increase muscle movement
• Improve musculoskeletal function
• All help to diminish and prevent muscle cramping.

Adjustments will restore proper alignment and restore nerve communication. These treatments help to release toxins, loosen and relax the muscle tissues, and provide relief.

Say Goodbye to Pain With Chiropractic

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 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, don't hesitate to 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

Blyton, Fiona, et al. "Non-drug therapies for lower limb muscle cramps." The Cochrane Database of systematic reviews vol. 1,1 CD008496. 18 Jan. 2012, doi:10.1002/14651858.CD008496.pub2

FIELDS, A. "Leg cramps." California Medicine vol. 92,3 (1960): 204-6.

Garrison, Scott R et al. "Magnesium for skeletal muscle cramps." The Cochrane Database of systematic reviews vol. 9,9 CD009402. 21 Sep. 2020, doi:10.1002/14651858.CD009402.pub3

Katzberg, Hans D. “Case Studies in Management of Muscle Cramps.” Neurologic clinics vol. 38,3 (2020): 679-696. doi:10.1016/j.ncl.2020.03.011

Miller, Kevin C et al. "An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps." Journal of athletic training vol. 57,1 (2022): 5-15. doi:10.4085/1062-6050-0696.20

Miller, Timothy M, and Robert B Layzer. "Muscle cramps." Muscle & nerve vol. 32,4 (2005): 431-42. doi:10.1002/mus.20341

Introduction

We are constantly on the move throughout the day, from walking, running, or standing doing errands, all because of the lower and upper portions of our bodies. The body is a complex, unique machine with upper and lower portions with specific jobs and functions. The body’s upper portion provides mobility and functionality to the neck, shoulders, head, arms, and hands. At the same time, the lower portion of the body offers stability and motor functions to the hips, legs, knees, and feet. When there are issues that affect the body, it can, over time, causes stress in the musculoskeletal system and affect the joints in the lower extremities, thus invoking pain and disability. Today’s article looks at tibial stress fractures, how they affect the lower body, and how treatments like the MET technique can help the lower body. We provide and mention valuable information about our patients to certified medical providers who offer therapy techniques like the MET combined with treatment care for individuals with tibial stress fractures in their lower body extremities. We encourage each patient by referring them to our associated medical providers based on their findings appropriately. We acknowledge that education is a spectacular way when asking our providers the most helpful questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., utilizes this information as an educational service. Disclaimer

What Are Tibial Stress Fractures?

Have you been dealing with heaviness in your legs and feet? What about unwanted pain radiating from your knees to your shin? Or do your feet constantly feel tired? Many of these issues could be due to muscle overload on the lower extremities associated with tibial stress fractures. Research studies reveal that when the lower extremities are subjected to repeated mechanical stress, that can cause microscopic fractions in the tibia. This condition is most common in military recruits, athletes, and runners. In the book “Clinical Applications of Neuromuscular Techniques” by Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., stated that two types of stress fractures can occur in the tibia that is the result of tibial stress fractions. They are:

• Fatigue stress fracture: Caused by repeated abnormal muscular stress (torque) applied to the normal bone, which has appropriate elastic resistance potential and density.
• Insufficiency stress fracture: Caused by normal muscular forces applied to mineral-deficient or abnormally inelastic bone.

How Do They Affect The Lower Body?

Numerous factors can cause stress fractures in the lower body extremities, affecting motor-sensory and mobility function. Some of the factors associated with stress fractures in the tibia include:

• A sudden increase in training or activities
• Uneven surfaces
• Inappropriate footwear
• Inappropriate running style
• Misalignment in the lower limbs

Studies have revealed that when these risk factors cause the development of stress fractures in the legs, it can lead to symptoms like pain and swelling in the legs and feet. If it continues without treatment over time can cause the bones to weaken and can be confused with musculoskeletal disorders like osteoporosis or shin splits. 

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*

Introduction

Many people don’t often realize that stability and balance are two of the most reliable abilities to keep the body from falling, and it is often taken for granted from the earlier stages, where infants and toddlers are learning to stand upright, to adulthood where we are walking, running or performing any physical activities. Our bodies are complex machines comprised of upper and lower portions that provide balance and stability. The lower half of our bodies helps stabilize and balance the upper half weight and allows us to move around. This is known as gait. However, when the body begins to age naturally or chronic issues begin to affect the muscles and cause an imbalance in the lower half, it can lead to many disorders associated with these imbalances. Today’s articles examine what gait is, how gait disturbances are associated with the body, and how the MET technique improves gait. We provide information about our patients to certified medical providers that offer available therapy techniques like MET (muscle energy techniques) for individuals dealing with chronic conditions associated with gait disturbances that could affect a person’s ability to walk. We encourage each patient appropriately by referring them to our associated medical providers based on their diagnosis results. We accept that education is a spectacular way when asking our providers the most crucial questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., assesses this information as an educational service. Disclaimer

What Is Gait?

Have you been dealing with issues when walking for a short or long distance? Do your feet or ankles seem to feel tired or ache when stepping? Or have you been dealing with mobility issues in your hips? Many of these issues are associated with gait and can cause balance disturbances in the body. So what is gait? In the book by Leon Chaitow, N.D, D.O., and Judith Walker DeLany, L.M.T, titled “Clinical Applications of Neuromuscular Techniques,” gait is defined as how you walk and how each lower body section contributes to how you walk. This includes:

• Feet
• Ankles 
• Knees
• Hips 
• Spine

The book also mentions how a person progresses from one location to another using muscular action and gravity to make them walk. Two functional units are in a casual relationship contributing to gait: the passenger and locomotor units. The passenger unit consists of the upper extremities, like the head, neck, arms, trunk, and pelvis, to be the center of gravity when moving forward. At the same time, the locomotor unit comprises the pelvis and lower extremities, like the legs, knees, feet, and ankles, to support the weight of the upper extremities and perform structural stability and mobility to make the body move forward.

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*

Flexibility is the ability of joint/s to move through an unrestricted range of motion. To maintain joint health, the cartilage and structures within the joint need a constant supply of blood, nutrients, and synovial fluid to move through a full range of motion. The range of motion is influenced by the mobility of the soft tissues that surround the joint. These soft tissues include muscles, ligaments, tendons, joint capsules, and skin. Factors affecting the loss of normal joint flexibility include injury, inactivity, or little to no stretching. Although flexibility varies for everybody, minimum ranges are necessary for maintaining total body health. Injury Medical Chiropractic and Functional Medicine Clinic can create a personalized stretching program to restore joint flexibility.

Joint Flexibility

Body Effects

• Not stretching the body can lead to fatigue, weakness, and soft tissue shortening.
• The effect can be particularly noticeable in weight-bearing joints like the hips and knees.
• If the joints become weak, the risk of injury increases.
• Inflexible muscles tire more quickly, causing opposing muscle groups to work harder.
• Muscle fatigue can lead to muscular injuries and the inability to protect the joints from more severe injuries.
• Decreased flexibility can also lead to added stress on structures and tissues in a different body area from the source of the inflexibility.
• An example is tendonitis in the knee can be related to calf tightness.

Stretching Routine Benefits

Research has shown that stretching can help improve flexibility and, as a result, the range of motion of the joints. Benefits include:

• Improved performance in physical activities.
• Improved ability with daily activities.
• Decreased risk of injuries.
• Increase circulation.
• Improved muscle function.

Testing

Flexibility can be measured with functional tests. These tests measure the joint's range within common movement patterns. Using these tests, areas of inflexibility can be identified and addressed. The tests look at the following:

• Neuromuscular coordination.
• How the muscles return to a normal resting state.
• Blood circulation and recirculation.
• Typical assessment areas include the lower back, hips, hamstrings, knees, and feet.

Stretching the Body

Developing a regular stretching routine to be incorporated into a training program is recommended. A stretching routine should cover all the major muscle groups of the body as well as any specific muscle groups. Implementing a physical therapy stretching program can help individuals stay motivated, as gaining flexibility takes time. It can take several weeks of consistent, regular stretching for improvement.

• Stretching with a physical therapist will target the largest areas of inflexibility.
• Stretching sessions can be 20 minutes or more.
• Once these areas have been addressed, the therapist will move on to more specific areas.
• The therapist will train the individual how to stretch at home.

The therapist will provide specific guidelines that should be followed for stretching at home:

• Stretching when muscles are cold could lead to a strain or pull.
• Warming up before stretching is recommended as it increases the blood flow and temperature of the muscles, ligaments, and tendons, improving the elasticity and functioning of the tissues.
• Begin each stretch slowly and gently.
• Maintain the stretch position for 30 seconds, and gradually increase to 1-2 minutes.
• Maintain a regular breathing pattern when stretching.
• Stay relaxed, and do not bounce.
• There should be pulling or tightness but not pain.
• Static stretching should gradually go through the full range of motion until the resistance is felt.
• Stretch to the point of tightness and then just beyond.
• Gradually release the stretch.
• Repeat daily.

A stretching therapy program keeps the body loose and effectively increases the mobility of all soft tissues.

Full Body Stretching

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 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 directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and 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 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

Behm DG. Does stretching affect performance? In: The Science and Physiology of Flexibility and Stretching. Kindle edition. Routledge; 2019.

Berg, K. Stretching fundamentals. In: Prescriptive Stretching. 2nd ed. Kindle edition. Human Kinetics; 2020.

Ghasemi, Cobra, et al. "The effect of soft tissue manipulation and rest on knee extensor muscles fatigue: Do torque parameters and induced perception following muscle fatigue have enough reliability?." Journal of family medicine and primary care vol. 9,2 950-956. 28 Feb. 2020, doi:10.4103/jfmpc.jfmpc_838_19

Gordon BT, et al., eds. Flexibility assessments and exercise programming for apparently healthy participants. In: ACSM's Resources for the Exercise Physiologist. 3rd ed. Kindle Edition. Wolters Kluwer; 2022.

Hui, Alexander Y et al. "A systems biology approach to synovial joint lubrication in health, injury, and disease." Wiley interdisciplinary reviews. Systems biology and medicine vol. 4,1 (2012): 15-37. doi:10.1002/wsbm.157

Lindstedt, Stan L. "Skeletal muscle tissue in movement and health: positives and negatives." The Journal of experimental biology vol. 219, Pt 2 (2016): 183-8. doi:10.1242/jeb.124297

Introduction

The hips in the lower portions of the body allow the legs to move the host from one location to another and provide stability to support the upper body’s weight. The hips will enable the torso to twist and turn without feeling pain. This is due to the various muscles and ligaments surrounding the pelvic bone and hip joint socket that allow the motion to be possible. However, when various injuries or factors start to affect the multiple muscles surrounding the pelvis or there is a chronic condition like osteoarthritis that causes wear and tear on the hip joints can cause underlying symptoms associated with the hips and cause many individuals to have difficulty when moving around. Luckily there are ways to improve hip mobility and the surrounding muscles in the hip and pelvic region of the body. Today’s article looks at the causes of the development of tight hips in the body and how different stretches can release tight hip flexor muscles. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from hip pain and its correlating symptoms that can affect the musculoskeletal system in the hips, legs, and lumbar region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

What Causes The Body To Develop Tight Hips?

Have you been dealing with hip mobility issues? When you sit, do you feel uncomfortable, and your hip muscles become tight? Or do you have a decreased range of motion when moving your hips? It could correlate with your hips if you have been experiencing muscle pain issues in the lower extremities. The hips help stabilize the upper and lower portions of the body while providing the full leg’s range of motion. When a person begins to sit for long periods or twist their body in a weird position, it can cause the muscles that surround the hips to become shortened. Other issues, like chronic conditions, can play a role in developing tight hip flexors. Studies reveal that various pathologies affecting the hips, lumbar spine, and lower extremities could strongly correlate with restricted hip mobility that can cause harmful effects that can affect the hips. To that point, some of the symptoms associated with tight hip flexors include:

• Instability
• Hypermobility
• Limited range of motion
• Reduce muscle strength in the groin
• Muscle cramps
• Sharp, sudden pain in the hips, pelvis, or groin
• Low back pain
• Piriformis syndrome

Other research studies mentioned that hypermobility disorders could affect the hip joints. Hypermobility disorders like EDS (Ehlers-Danlos syndrome) could cause micro or macro-trauma on the hip joint and affect the ligaments surrounding the hip joint. To that point, it can cause the hip flexor muscles to become tense and potentially affect how a person moves, which then causes soft tissue injuries and chronic pain.

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*

Introduction

The various muscles and tendons surrounding the foot play an important role as they provide stability to the lower parts of the body and allow the individual to move and flex their feet. These various muscles and tendons help support the ankles and allow leg movement. Many people will be on their feet constantly as the world moves and sometimes have to deal with various issues affecting their ability to walk. As the body naturally ages, many people will begin to shuffle their feet around, which causes strain on the foot muscles and can affect the calves and legs over time. To that point, it can lead to foot pain and other conditions that can affect the individual. Other issues that can affect the feet and its muscle could be incorrect footwear, how they are standing, or how they walk. When this happens, conditions like plantar fasciitis and trigger point pain can affect the feet differently. Today’s article focuses on the superficial intrinsic foot muscles, how trigger points and plantar fasciitis correlate with foot pain, and how to strengthen the foot muscles. We refer patients to certified providers incorporating techniques and therapies in the lower body extremities of trigger points affecting the feet. This helps many people with trigger point pain symptoms associated with plantar fasciitis along the intrinsic foot muscles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

The Superficial Intrinsic Foot Muscles

As stated earlier, the foot has various muscles and tendons that allow stability to the ankles and allow movement when a person is walking. The foot has two muscle groups: the extrinsic and intrinsic muscles. Today we will look at the intrinsic foot muscles and how important these muscles are in the foot. Studies reveal that the intrinsic foot muscles are highly important as they are contained to the foot and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles are superficial and help keep the toes straight while providing flexion and extension when in motion. The foot has about 29 muscles, including 10 surrounding the foot and ankle, while the other 19 are intrinsic and provide the roles for gait and posture. The 19 intrinsic muscles have the following:

• Abductor Hallucis
• Quadratus Plantae
• Flexor Hallucis Brevis
• Flexor Digitorum Brevis
• Abductor Digiti Minimi
• Flexor Digiti Minimi
• The Interossei Muscles
• The Lumbricals

These muscles allow individuals to walk, run, or jog without pain. However, when the intrinsic muscles become impaired, studies reveal that intrinsic foot muscle function could be linked to various foot conditions that affect a person’s walking ability.

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*

For individuals experiencing pelvis pain symptoms and associated problems, can integrating pelvic floor physical therapy exercises help with treatment and prevention?

Pelvic Floor Physical Therapy

• The pelvic floor muscles are located at the base of the pelvis and protect the pelvic organs like the vagina, cervix, uterus, bladder, urethra, and rectum. (U.S. Food and Drug Administration. 2019)
• They provide posture support, aid in orgasm function, facilitate sphincter function, and help pump lymphatic blood. (Dulcegleika Vilas Boas Sartori, et al., 2021) (Varuna Raizada, Ravinder K. Mittal. 2008)

When the muscles fail to function correctly, individuals can experience symptoms like:

1. Painful intercourse
2. Prolapse - when an organ or tissue drops or shifts out of place.
3. Urinary incontinence
4. Constipation problems
5. These conditions are common in pregnant individuals or older women.

These symptoms can be treated with pelvic floor physical therapy to alleviate discomfort. Pelvic floor physical therapy can help women and individuals with vaginas:

• Alleviate issues like painful sex, urinary leakage, and prolapse.
• In physical therapy, individuals work on breathing, relaxation, and lengthening and strengthening techniques to train their muscles to function optimally.

Causes of Pelvic Floor Issues

Pelvic floor dysfunction tends to happen with age, during pregnancy, or in combination with events like the postpartum period and menopause, which can lower hormone levels.

• Individuals who are pregnant are especially prone to pelvic floor issues but might not know they have a problem.
• The pregnancy weight of a uterus can pressure and strain the muscles.
• Vaginal childbirth can also stretch or weaken the muscles. (Ilaria Soave, et al., 2019)

Symptoms

Symptoms can include: (Columbia Surgery. 2022)

• Pain in the pelvis region
• Back pain
• Painful urination
• Constipation
• Urinary leakage or incontinence
• Stool leakage or incontinence
• Painful intercourse
• If left untreated, these symptoms can worsen over time.

Pelvic Floor Physical Therapy

An individual will meet with a specialist to discuss symptoms and undergo a physical examination that includes:

1. Pelvic floor exam.
2. Evaluation of posture, mobility, and core strength.
3. Once the initial exams and evaluation are complete, the practitioner will go over pelvic floor exercises and provide a treatment plan.
4. Recommended exercises vary based on symptoms but focus on relaxing, stretching, and/or strengthening muscles.

Muscle Relaxation

• To relax the muscles, a therapist may recommend breathing exercises.
• For pregnant individuals, this means timing breaths with contractions.
• For individuals experiencing constipation, breathing exercises can help the body relax and reduce strain.

Stretching Muscles

• Stretching can help relieve muscle tightness and stiffness.
• A therapist may help stretch the pelvic floor through various therapy modalities.
• This type of physical therapy can help loosen tight muscles or help gently reset dislocated organs back into place.

Strengthening Muscles

• After the pelvic floor is loose and relaxed, the focus typically switches to strengthening the muscles.
• Strength work may target abdominal muscles or the pelvic floor muscles themselves.

With time, commitment, and targeted treatment, individuals can use pelvic floor physical therapy to loosen tissues, strengthen muscles, and restore function.

Spinal Decompression In Depth

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 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

U.S. Food and Drug Administration. (2019). Pelvic organ prolapse (pop).

Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2021). Pelvic floor muscle strength is correlated with sexual function. Investigative and clinical urology, 62(1), 79–84. https://doi.org/10.4111/icu.20190248

Raizada, V., & Mittal, R. K. (2008). Pelvic floor anatomy and applied physiology. Gastroenterology clinics of North America, 37(3), 493–vii. https://doi.org/10.1016/j.gtc.2008.06.003

Soave, I., Scarani, S., Mallozzi, M., Nobili, F., Marci, R., & Caserta, D. (2019). Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Archives of gynecology and obstetrics, 299(3), 609–623. https://doi.org/10.1007/s00404-018-5036-6

Columbia Surgery. (2022). Pelvic floor disorders: frequently asked questions.

Nowadays, individuals trying to avoid surgery have more therapy options. Can regenerative medicine help treat neuromusculoskeletal injuries?

Regenerative Medicine

Regenerative medicine utilizes the body's raw cells and is used in cancer treatment and to reduce the risk of infections. (American Cancer Society. 2020) Researchers are looking for other ways to use these cells in medical therapies.

What are These Cells

• Stem cells are unspecialized cells that can develop into any cell and in certain cases renew themselves an unlimited number of times. (National Institutes of Health. 2016)
• These cells are found in embryos and adult cells.
• There are two types of cells - pluripotent and somatic. (National Institutes of Health. 2016)
• These cells can transform and become any of the cells in the body.
• Somatic cells or adult stem cells can form tissue or an entire organ. (National Institutes of Health. 2016)

Therapy

Regenerative cell therapy uses these cells as a treatment for a disease or condition.

• Regenerative cells are given to individuals to replace cells that have been destroyed or have died.
• In the case of cancer, they may be used to help the body regain the ability to produce regenerative cells after treatment. (American Cancer Society. 2020)
• For individuals with multiple myeloma and certain types of leukemia, regenerative cell therapy is used to eliminate cancer cells.
• The therapy is called graft-versus-tumor effect/GvT, where a donor's white blood cells/WBCs are used to eliminate the cancerous tumor. (American Cancer Society. 2020)

What They Can Treat

This is a new treatment that is still going through research. The Food and Drug Administration has only approved it for certain cancers and conditions that affect the blood and immune system. (Centers for Disease Control and Prevention. 2019) Regenerative cell therapy is FDA-approved to treat: (National Cancer Institute. 2015)

• Leukemia
• Lymphoma
• Multiple myeloma
• Neuroblastoma
• It is also used to decrease the risk of infection after regenerative cell transplantation in individuals with blood cancers. (U.S. Food & Drug Administration. 2023)

Researchers are studying how these cells can treat other conditions. Clinical trials are analyzing how to use the therapy for neurodegenerative diseases like:

• Parkinson's
• Alzheimer's
• Multiple sclerosis - MS
• Amyotrophic lateral sclerosis - ALS. (Riham Mohamed Aly. 2020)

Cell Types

During regenerative cell therapy, the cells are given through an intravenous line. The three places where blood-forming cells can be obtained are bone marrow, the umbilical cord, and blood. Transplants can include: (American Cancer Society. 2020)

Autologous

• The cells are taken from the individual who will be receiving the therapy.

Allogeneic

• The cells are donated by another individual.

Syngeneic

• The cells come from an identical twin, if there is one.

Safety

The therapy has shown to provide benefits but there are risks.

• One risk is known as graft-versus-host disease - GVHD.
• It occurs in one-third to half of allogeneic recipients.
• This is where the body does not recognize the donor's white blood cells and attacks them causing problems and symptoms throughout the body.
• To treat GVHD medications are given to suppress the immune system to stop attacking the donor cells. (American Cancer Society. 2020)

Other potential risks can include: (American Cancer Society. 2020)

• Cancer relapse
• New cancer
• Hepatic veno-occlusive disease
• Post-transplant lymphoproliferative disorder - PTLD

Future Possibilities

The future of regenerative cell therapy is promising. Research is ongoing to find out how these cells can treat conditions and find new ways to treat and cure diseases.

Regenerative medicine has been researched for over twenty years for conditions like macular degeneration, glaucoma, stroke, and Alzheimer's disease. (National Institutes of Health. 2022) This therapy is a new medical treatment that could be used in future therapies as part of a multidisciplinary approach to neuromusculoskeletal injuries and conditions.

Quick Patient Initiation Process

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 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 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 Cancer Society. (2020). How stem cell and bone marrow transplants are used to treat cancer.

National Institutes of Health. (2016). Stem cell basics.

Centers for Disease Control and Prevention. (2019). Stem cell and exosome products.

National Cancer Institute. (2015). Stem cell transplants in cancer treatment.

U.S. Food & Drug Administration. (2023). FDA approves cell therapy for patients with blood cancers to reduce risk of infection following stem cell transplantation.

Aly R. M. (2020). Current state of stem cell-based therapies: an overview. Stem cell investigation, 7, 8. https://doi.org/10.21037/sci-2020-001

American Cancer Society. (2020). Stem cell or bone marrow transplant side effects.

National Institutes of Health. (2022). Putting stem cell-based therapies in context.

Gender is a concept with many facets. Everyone has a gender expression. Can learning about gender expression help healthcare professionals provide better and more effective treatment plans for the LGBTQ+ community?

Gender Expression

Gender expression refers to the ways that individuals present their gender identity and themselves. This can be clothing, haircuts, behaviors, etc. For many, there can be confusion between what society expects from their gender and how these individuals choose to present themselves. Gender expression is constructed from the culture that surrounds it, meaning that there may be a shared social expectation about gender. It can also mean that the same feminine hair or clothing style in one setting could be seen as masculine in another.

• Society tries to regulate expression by making women wear certain kinds of clothes, and men other kinds, in order to participate in school, work, and when in public.
• When cultures enforce gender norms it is known as gender policing, which can range from dress codes to physical and emotional punishment.
• Creating a safe space for all genders requires awareness of these explicit or implicit gender norms so policing can be prevented. (José A Bauermeister, et al., 2017)
• Research has shown that there are increased rates of discrimination against transgender and gender-nonconforming individuals compared with bias against those who are LGBTQ. (Elizabeth Kiebel, et al., 2020)

Health Care

• Gender expression can and does affect access to and quality of health care.
• Individuals with a gender expression that is different from what is expected for their assigned sex at birth may experience increased bias and harassment from providers. (Human Rights Watch. 2018)
• A significant percentage of patients feared health workers would treat them differently because of their expression. (Cemile Hurrem Balik Ayhan et al., 2020)
• Minority stress has been shown to play an important role in health imbalances. (I H Meyer. 1995)
• Research suggests that gender expression is a part of the minority stress described by cisgender sexual minorities and gender minorities. (Puckett JA, et al., 2016)

Better Training

• The effects of gender expression are different depending on a person's sex, gender identity, and their setting.
• However, doctors do need to know a person's sex that was assigned at birth to be able to do proper screening tests, like screening for prostate or cervical cancer.
• One way to be more affirming is for the doctor to introduce themselves first, using their own pronouns.
• Health workers should ask everyone what name they prefer to be called and what pronouns they use.
• This simple act invites the patient to share without creating awkward uneasiness.

Each person chooses how to present themselves to the world, and we respect all. We at Injury Medical Chiropractic and Functional Medicine Clinic will work to address the effects of minority stress on health disparities and raise awareness of the ways to continually improve positive experiences for LGTBQ+ individuals seeking inclusive health care for neuromusculoskeletal injuries, conditions, fitness, nutritional, and functional health.

Revolutionizing Healthcare

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 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 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

Bauermeister, J. A., Connochie, D., Jadwin-Cakmak, L., & Meanley, S. (2017). Gender Policing During Childhood and the Psychological Well-Being of Young Adult Sexual Minority Men in the United States. American journal of men's health, 11(3), 693–701. https://doi.org/10.1177/1557988316680938

Kiebel, E., Bosson, J. K., & Caswell, T. A. (2020). Essentialist Beliefs and Sexual Prejudice Toward Feminine Gay Men. Journal of homosexuality, 67(8), 1097–1117. https://doi.org/10.1080/00918369.2019.1603492

Human Rights Watch. "You Don't Want Second Best"—Anti-LGBT Discrimination in US Health Care.

Ayhan, C. H. B., Bilgin, H., Uluman, O. T., Sukut, O., Yilmaz, S., & Buzlu, S. (2020). A Systematic Review of the Discrimination Against Sexual and Gender Minority in Health Care Settings. International journal of health services: planning, administration, evaluation, 50(1), 44–61. https://doi.org/10.1177/0020731419885093

Meyer I. H. (1995). Minority stress and mental health in gay men. Journal of health and social behavior, 36(1), 38–56.

Puckett, J. A., Maroney, M. R., Levitt, H. M., & Horne, S. G. (2016). Relations between gender expression, minority stress, and mental health in cisgender sexual minority women and men. Psychology of Sexual Orientation and Gender Diversity, 3(4), 489–498. https://doi.org/10.1037/sgd0000201

Introduction

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

How Does Muscle Pain Affect The Body?

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

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

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*

Range of motion - ROM measures the movement around a joint or body part. When stretching or moving certain body parts, like a muscle or joint, the range of motion is how far it can move. Individuals with a limited range of motion cannot move a specific body part or joint through its normal range. Measurements are different for everybody, but there are ranges that individuals should be able to achieve for proper function. The Injury Medical Chiropractic and Functional Medicine Team can address issues/problems with ROM through a personalized treatment plan to alleviate symptoms and restore mobility and flexibility.

Improve Range of Motion

Over 250 joints in the body move from extension to flexion and are responsible for all of the body's movements. These include the ankles, hips, elbows, knees, and shoulders. Tightness in the hips and ankles can decrease ROM when lifting an object, limiting the muscles' ability. Form and strength potential becomes limited and suffers from an inadequate ROM. When form and posture are compromised, pain and injuries can result. There are many reasons why this can occur, including:

• Tight and stiff muscles.
• Trying to use these muscles can worsen the condition, limiting ROM further.
• A limited ROM in the back, neck, or shoulders may be due to the body being out of natural alignment.
• Repetitive motions, injuries, and everyday wear and tear can shift proper alignment and limit movement.
• Inflammation and swelling around the joints.
• Pain symptoms that are causing mobility issues.
• Joint disorders.

These symptoms can come from:

• Injuries
• Infections
• Conditions like arthritis, brain, nerve, and/or muscle disorders.
• A mild to moderate range reduction may be caused by a sedentary lifestyle or insufficient physical activity.

Daily Living

Decreased range of motion and poor mobility can hinder the body from lifting objects, job occupation performance, and household tasks. A healthy physical ability is what determines independent aging and optimal function.

• Restoring a healthy range of motion can improve physical performance during work, home, and sports activities.
• An improved range of motion allows the affected muscles to work at longer lengths, build strength and relieve tension.
• A stronger muscle capable of contracting efficiently through larger ranges prevents and decreases the risk of injury.

Chiropractic Restoration

Chiropractic care can realign the body and improve range of motion to optimal levels.

Therapeutic and Percussive Massage

• Massage therapy will release the tightness, keep the muscles loose, and increase circulation.
• This prepares the body for chiropractic adjustments and spinal decompression.

Decompression and Adjustments

• Non-surgical mechanical decompression realigns the body to a pliable state.
• Chiropractic adjustments will reset any misalignments, restoring flexibility and mobility.

Exercises

• A chiropractor will provide physical therapy-type exercises and stretches to mobilize the joints.
• Targeted exercises and stretches will help to maintain the adjustments and strengthen the body to prevent ROM worsening and future injuries.

Secrets of Optimal Wellness

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 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, don't hesitate to 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

Behm, David G et al. "Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review." Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme vol. 41,1 (2016): 1-11. doi:10.1139/apnm-2015-0235

Calixtre, L B et al. "Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomized controlled trials." Journal of oral rehabilitation vol. 42,11 (2015): 847-61. doi:10.1111/joor.12321

Fishman, Loren M. "Yoga and Bone Health." Orthopedic nursing vol. 40,3 (2021): 169-179. doi:10.1097/NOR.0000000000000757

Lea, R D, and J J Gerhardt. "Range-of-motion measurements." The Journal of Bone and joint surgery. American Volume vol. 77,5 (1995): 784-98. doi:10.2106/00004623-199505000-00017

Thomas, Ewan, et al. "The Relation Between Stretching Typology and Stretching Duration: The Effects on Range of Motion." International Journal of sports medicine vol. 39,4 (2018): 243-254. doi:10.1055/s-0044-101146

Introduction

The thigh muscles provide mobility and stability to the hips and upper body. They allow for leg extension and flexion while also stabilizing the pelvis. The adductors and hamstrings are two muscle groups that work together to enable running, jumping, squatting, and sprinting. However, overuse of these muscles can lead to musculoskeletal pain, which can cause discomfort and misalignment in the body. This article will focus on the hamstring and adductor muscles, the impact of muscle pain and strain on these muscles, and how MET therapy can help. We utilize and incorporate valuable information about our patients to certified medical providers using MET therapy to relieve chronic muscle pain associated with the hamstrings and the adductor muscles. We encourage and refer patients to associated medical providers based on their findings while supporting that education is a remarkable and fantastic way to ask our providers the essential questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., comprises this information as an educational service. Disclaimer

Hamstrings & Adductor Muscles

Do you feel pain in your upper thigh? Does walking or running cause you problems? Are you experiencing pain in your knees when you stretch your legs? These issues may be related to the hamstrings and adductor muscles in your thighs. These muscles provide stability and mobility to your thighs and lower extremities. Studies reveal that the hamstring muscles are a group of three individual muscles that play a crucial role in daily activities. Their main functions include:

• Hip extension and knee flexion.
• Allowing you to perform a variety of movements, such as standing and sprinting.
• Jumping.

The hamstrings and adductors play important roles in a person’s gait cycle and in controlling pelvic posture. The hamstrings help extend the hip and flex the knee, while the adductor muscles stabilize the hips and pelvis. Research studies show that the adductor muscles come from the pelvis and stop at the femur in the legs. They are crucial for stabilizing the pelvis and maintaining balance in the lower limbs during walking. However, these muscles are prone to injuries despite their significant roles in lower extremity function.

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*

Introduction

The musculoskeletal system allows the various muscle groups to surround the bones and joints through ligaments and muscle tissues that help with mobility and stabilizes the skeletal structure from pain. As the body ages naturally, the muscles, bones, and joints get affected as numerous factors begin to cause the body to be dysfunctional. Many of these factors could take a toll on the body and cause bone mass density loss, leading to osteoporosis. A person experiencing osteoporosis can generate overlapping risk profiles affecting the body’s muscles and joints, leading to painful symptoms. Today’s article looks at osteoporosis, how it affects the muscles and joints, and how numerous treatments can help reduce osteoporosis symptoms. We utilize information about our patients to certified medical providers using MET therapy to mitigate the effects of osteoporosis on the musculoskeletal system. We encourage patients by referring them to associated medical providers based on their diagnosis while supporting that education is a remarkable way to ask our providers the most interesting and essential questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., comprises this information as an educational service. Disclaimer

What Is Osteoporosis?

If you’ve been experiencing severe back or hip pain or struggling to breathe, you may be experiencing osteoporosis. This condition causes bones to become porous, making them brittle and weak, and it affects around 200 million people worldwide, with women being more commonly affected than men, as studies revealed. Many risk factors can cause bones to deteriorate quickly and become weaker, leading to an increased risk of fragility, fracture, and muscle and joint pain. Additional studies have revealed that some risk factors that can lead to osteoporosis development include:

• Race
• Ethnicity
• Age
• Sex
• Metabolic syndrome

Osteoporosis can often go undetected for a long time, with individuals only noticing symptoms such as a forward-curved upper back or a broken bone.

Osteoporosis Affecting The Muscles & Joints

Osteoporosis can affect the body’s bones, muscles, and joints, especially major skeletal portions like the spine, hips, wrists, and shoulders. Studies have shown that individuals with or without trauma can experience symptoms like pain due to osteoporosis caused by hormone deficiency. “Clinical Applications of Neuromuscular Techniques” by Dr. Leon Chaitow, N.D., D.O., and Dr. Judith Walker DeLany, L.M.T., explain that bone density can decrease when bone resorption happens faster than bone formation. This decrease in bone density could lead to joint fractures and cause musculoskeletal disorders that affect a person’s stability and mobility, leading to complaints in the upper and lower body extremities.

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*

Introduction

The muscles surrounding the hips in the lower extremities provide stability to the lumbar spine and pelvis while allowing mobility, flexibility, and rotation to the groin, legs, and thighs. The muscles surrounding the groin consist of three large muscle groups: the abdominals, iliopsoas, and adductors, which have a casual relationship with the various ligaments and soft tissues that can be succumbed to injuries or other symptoms that can lead to pain and misalignment to the body. This happens to many individuals who participate in sports or frequently exercise, which can cause strain near the groin and the surrounding muscles. Today’s article focuses on the causes of a groin strain, how it affects the hips and pelvis, and how available treatments can help reduce groin strain. We mention and provide valuable information about our patients to certified medical providers who use techniques like the MET and therapy for individuals with a groin strain and causing mobility issues when functioning. We give encouragement to patients by referring them to associated medical providers based on their diagnostic findings. We support that education is a marvelous way to ask our providers the most interesting questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer

The Causes Of Groin Strain

Have you experienced any mobility issues when walking? Do you feel pain near your hips or groin? Or do you feel muscle weakness in your thighs when exercising? Many of these issues are associated with a muscle strain near the groin affecting your lower body. The muscles surrounding the groin allow the legs and thighs to move around in flexion, rotation, and extension without feeling pain. However, when a person starts to feel pain radiating around their groin, it can become an issue if not taken care of. Studies reveal that some of the causes, like adductor strain or injuries from physical activities, can cause the muscle fibers in the three muscle groups of the groin to be in pain. In “Clinical Applications of Neuromuscular Techniques,” authors Leon Chaitow and Judith Walker DeLany, stated that chronic joint and soft tissue conditions predate presenting acute symptoms to the groin muscle regions. To that point, if a person has predisposed injuries in the groin muscles, it can affect how a person walks and functions when in motion, potentially leading to issues affecting the hips and pelvis.

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*

Resistance band exercises can be very useful for injury rehabilitation. As a part of a chiropractic neuromusculoskeletal treatment plan, personalized rehabilitation exercises using resistance bands can be prescribed to strengthen targeted areas of the body that require retraining due to an injury or condition. Resistance band training can effectively rehabilitate neck, shoulder, back, leg, knee, and ankle conditions and offer several advantages, from improving strength and posture to increasing mobility and improving joint health.

Resistance Bands

Resistance bands are rehabilitation and exercise equipment that provide consistent resistance throughout a specific exercise. They are rubberized bands or elastic cables that can be color-coded (different brands may vary in color progressions) to signify the amount of resistance they provide. These bands are great for all types of injuries to the joints or muscles and have been found to be effective in the following types:

• Weakened neck muscles from injury.
• Shoulder dislocation
• Tennis elbow
• Hip bursitis
• Knee injuries
• IT band syndrome
• Ankle sprains
• Improve flexibility for arthritis.

The body does need time to heal before engaging in exercise, especially after major muscle, ligament, or tendon tears. A chiropractor or physical therapist will inform the patient when they can begin. However, some areas can be worked out three days after an injury.

Benefits

Resistance bands can isolate strength training and stretching to specific muscles affected by surgery or a non-surgical injury/condition in chiropractic and physical therapy. They can help in the following:

• Increased circulation.
• Increased range of motion and flexibility.
• Increased muscular strength.
• Improved posture.
• Increased joint stability.
• Improved balance.

Added benefits:

• They are small, lightweight, and portable making them perfect for those that travel frequently.
• They are simple to use.
• They are cost-effective.
• They provide a whole-body workout.
• They come in different resistance levels to progress gradually.
• Safe for every fitness level.

Exercises

Exercises with bands can be used in standing, sitting, or lying down positions. Some may consist of movements with resistance coming from body weight. Other activities may require additional resistance. Lunges are an example of a simple exercise to help rehabilitate certain back conditions.

Injury Stages

Strength and resistance training is essential for healing from neuromusculoskeletal injuries and overall health.

Early/Acute Stage

• This stage entails light, gentle exercising that will allow damaged tissues to begin healing with simple movements to get circulation moving through the areas.

Second Stage

• Physical therapy exercises involving resistance bands.
• This gradually increases the weight on the injured bone, ligament, or muscle so the tissue can develop the ability to withstand strains from daily activities.

Late/Functional Stage

• This is the final step, in which the tissues are stressed through functional exercises to be fit enough to return to work, sports, and activities.

Exercises For Lower Back

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 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, don't hesitate to 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

Lee, Jae-Kwang, and Jae-Hong Lee. “Effect of the lumbar stabilization exercise on the height difference between shoulders and range of motion in older adults.” Journal of physical therapy science vol. 35,1 (2023): 46-50. doi:10.1589/jpts.35.46

Mikesky, A E et al. “Efficacy of a home-based training program for older adults using elastic tubing.” European journal of applied physiology and occupational physiology vol. 69,4 (1994): 316-20. doi:10.1007/BF00392037

Seguin, Rachel C et al. “The Efficacy of Upper-Extremity Elastic Resistance Training on Shoulder Strength and Performance: A Systematic Review.” Sports (Basel, Switzerland) vol. 10,2 24. 14 Feb. 2022, doi:10.3390/sports10020024

Seo, Myong-Won et al. “Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial.” International journal of environmental research and public health vol. 18,13 6762. 23 Jun. 2021, doi:10.3390/ijerph18136762

Yamamoto, Yutaro, et al. “Effects of resistance training using elastic bands on muscle strength with or without a leucine supplement for 48 weeks in elderly patients with type 2 diabetes.” Endocrine journal vol. 68,3 (2021): 291-298. doi:10.1507/endocrj.EJ20-0550

Spinal Stenosis Walking Issues: Stenosis means a narrowing. Spinal stenosis can happen in any spine region, but the neck and lower back are the most common locations. The spinal canal becomes narrower and can cause the nerves to become compressed, pinched, and irritated and can extend from the lumbar spine through the hips, buttocks, legs, and feet. Individuals with lumbar spinal stenosis may have difficulty walking caused by sensations of discomfort like numbness, electrical shocks, and pain, requiring the need to lean forward to relieve pressure and symptoms. Additionally, symptoms are likely to worsen the longer the walk. Chiropractic treatment can treat spinal stenosis because it corrects and re-aligns the spine, thus reducing pressure on the spinal cord, joints, and nerve roots.

Spinal Stenosis Walking Issues

The spine is made up of interlocking vertebrae. The regions are cervical, thoracic, lumbar, and sacral bones with a foramen opening. These openings form the protective tunnel/spinal canal surrounding the spinal cord. The spinal cord is a group of nerves that run through the tunnel. The narrowing suffocates the nerves supplying the lower extremities that can influence walking activity.

Symptoms

There may be no symptoms with early lumbar spinal stenosis. Most individuals develop symptoms gradually and may begin to notice them while walking or standing. These can include:

• Lower back pressure sensations when standing upright or walking.
• Leg numbness, tingling, weakness, burning, and/or cramping.
• Muscle weakness.
• Persistent pain in the back, hips, buttocks, or legs while walking.
• Difficulty lifting the top part of the foot - known as drop foot.
• Loss of sensation in the feet.
• A weak foot that drops/slaps down when walking.
• Loss of sexual ability.
• In more serious cases, severe numbness, bladder problems, and inability to stand.

Individuals begin to lean forward when symptoms start, bringing relief by reducing the pressure on the nerves. However, constantly leaning forward leads to other posture and health problems.

Diagnosis

A doctor or chiropractor will ask questions about symptoms and medical history and perform a complete physical examination to diagnose lumbar spinal stenosis. During the physical examination, a healthcare provider will look for signs, such as loss of sensation, weakness, and abnormal reflexes.

Tests:

• X-rays of the lumbar spine may show bone growths called spurs that push on spinal nerves and/or narrowing of the spinal canal.
• Imaging tests - A CT or MRI scan can provide a detailed look at the spinal canal and nerve structures.
• Other studies include - bone scans, myelogram, which is a CT scan that uses a color dye, and EMG, which is an electrical test of muscle activity.

Chiropractic Treatment

Chiropractic care combined with physical therapy is a tried-and-true treatment for spinal stenosis. A chiropractic treatment plan can include targeted and passive exercise programs. Targeted exercises involve strengthening the core and back muscles. Passive treatments include hot and cold therapy, massage, decompression, and electrical stimulation. The objective of chiropractic therapy is to:

• Strengthen muscles in the core and legs
• Correct posture and body mechanics.
• Improve mobility.
• Maintain ability to perform day-to-day activities.
• Recommend stretches.
• Educate on how to keep the spine and back muscles safe.
• Train on using devices like a back brace, cane, or walker properly.
• Advise about shoe inserts and splints.
• Suggest work and home environment modifications, such as ergonomics and cushions.

Chiropractic Relief

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 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, 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

Conway, Justin, et al. “Walking assessment in people with lumbar spinal stenosis: capacity, performance, and self-report measures.” The spine journal: official North American Spine Society journal vol. 11,9 (2011): 816-23. doi:10.1016/j.spinee.2010.10.019

Lurie, Jon, and Christy Tomkins-Lane. “Management of lumbar spinal stenosis.” BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234

Macedo, Luciana Gazzi, et al. “Physical therapy interventions for degenerative lumbar spinal stenosis: a systematic review.” Physical therapy vol. 93,12 (2013): 1646-60. doi:10.2522/ptj.20120379

Tomkins-Lane, Christy C et al. “Predictors of walking performance and walking capacity in people with lumbar spinal stenosis, low back pain, and asymptomatic controls.” Archives of physical medicine and rehabilitation vol. 93,4 (2012): 647-53. doi:10.1016/j.apmr.2011.09.023

Having and maintaining flexibility in the joints depends on the connective tissues surrounding the muscles. Proper lubrication in the connective tissues enables the fibers to slide over one another easily. Naturally occurring proteins collagen and elastin are key components of connective tissue that provide strength and elasticity. The more elastic the connective tissue, the more flexibility around the joint. If it is becoming difficult to stretch out or there is chronic stiffness and tightness, there are foods that help maintain flexibility and enhance overall health.

Foods That Help Maintain Flexibility

Joint flexibility means functioning connective tissues that join the skeleton and muscles and the ability of different body parts to extend and complete motions. Connecting tissues assists with movement and stabilization. These issues include:

Ligaments

• Ligaments can be band-shaped or string-shaped collagen fibers that connect bones.

Tendons

• Tendons are similar to ligaments and are band or string shaped but connect muscles to the bones.

Fascia

• Fascia is a densely woven mesh that wraps around the blood vessels, bones, muscles, organs, and nerves.

Flexibility keeps the muscles active and mobile as they are necessary for daily physical activities. When these tissues become stiff from inactivity or an unhealthy diet, it limits the body’s range of movement and increases the risk of injury. Stretching improves flexibility, and adding foods to a nutrition plan will help maintain limberness.

Nutrition

A nutrition plan full of vitamins, minerals, and antioxidants will nourish connecting tissues and cells and increase collagen production. Foods rich in essential fatty acids/EFAs, vitamin C, sulfur, and water will promote healthy connective tissue for enhanced flexibility.

Fatty Acids

• Essential fatty acids include omega-3 and omega-6, primarily found in fish, flax seeds, and liquid oils.
• These fatty acids are essential because they cannot be made in the body.
• Foods like fatty fish, flax seeds, walnuts, or supplements, can help achieve the proper ratio.
• For individuals not too keen on fish, consider omega-3 supplements.

Collagen

• Collagen is the main protein from connective tissue, and vitamin C is essential for collagen production.
• Vitamin C-rich foods - oranges, bell peppers, broccoli, strawberries, tomatoes, leafy green vegetables, raspberries, pineapple, cruciferous vegetables, parsley, and watermelon.
• Make various smoothie recipes for breakfast or an afternoon snack.
• For increased protein synthesis, add branched-chain amino acids.

Sulfur

• Sulfur helps maintain the flexible bonds in connective tissues.
• Animal proteins that provide sulfur include fish, poultry, beef, and eggs.
• Vegetable sources include Brussels sprouts, cabbage, broccoli, cauliflower, onions, and garlic.

Hydration

Water is not considered food as it contains no calories, but it is vital as it makes up 76 percent of the muscles. A high percentage of water content is the key to muscle elasticity. When the body is dehydrated, it holds onto water, causing fluid retention and stiffness. The more the muscles stay dehydrated, the more they have trouble recovering from physical activities, fatigue levels increase, the range of motion decreases, and the risk of injury increases. Don’t wait until you are thirsty. Stay hydrated throughout the day to keep the joints lubricated and energy levels high.

Fruits high in water include:

• Strawberries
• Watermelon
• Cantaloupe
• Peaches
• Grapefruit
• Pineapple
• Apples
• Pears

Vegetables high in water include:

• Cucumber
• Lettuce
• Zucchini
• Celery
• Eggplant

Limit Salt and Sugar Intake

• Processed foods tend to have a high salt content.
• Too much salt causes the joints to swell as the body retains fluid.
•  Keeping sugar intake low is important in enhancing flexibility.
• This is because sugar breaks down the collagen in the skin and connective tissues.
• This means avoiding processed foods, ready meals, and junk food.

Flexibility can be improved by eliminating foods that destroy collagen, focusing on foods that reduce insulin spikes, and maintaining hydration in the connective tissues. A nutritionist can develop a personalized nutrition plan for optimal neuromusculoskeletal health.

Foods That Help Maintain Flexibility

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 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 directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and 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, don't hesitate to 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

Beba, Mohammad et al. “The effect of curcumin supplementation on delayed-onset muscle soreness, inflammation, muscle strength, and joint flexibility: A systematic review and dose-response meta-analysis of randomized controlled trials.” Phytotherapy research: PTR vol. 36,7 (2022): 2767-2778. doi:10.1002/ptr.7477

Kviatkovsky, Shiloah A et al. “Collagen peptide supplementation for pain and function: is it effective?.” Current opinion in clinical nutrition and metabolic care vol. 25,6 (2022): 401-406. doi:10.1097/MCO.0000000000000870

MacKay, Douglas, and Alan L Miller. “Nutritional support for wound healing.” Alternative medicine review: a journal of clinical therapeutic vol. 8,4 (2003): 359-77.

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

Zdzieblik, Denise, et al. “Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides.” Applied physiology, nutrition, and metabolism = Physiologie applique, nutrition et metabolism vol. 42,6 (2017): 588-595. doi:10.1139/apnm-2016-0390

Introduction

Everyone worldwide knows that feet are important. The feet allow many individuals to run, walk, or jog for long periods without feeling pain for a moderate amount of time. To that point, the various muscles and tendons surrounding the foot provide full body flexion, extension, and stability. Even though it is very easy to get in the recommended amount of steps into being healthy, around 75% of individuals will have foot pain that can impact their ability to walk. One of the most common foot pains is plantar fasciitis, which can become a painful foot condition if it is not treated as soon as possible. Today’s article looks at plantar fasciitis, its symptoms, how trigger points correlate, and treatments for it. We refer patients to certified providers incorporating techniques and therapies for individuals dealing with plantar fasciitis. By locating where the trigger points are coming from, many pain specialists can develop a treatment plan to reduce the effects that plantar fasciitis is causing on the feet. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

What Is Plantar Fasciitis?

Have you been dealing with constant heel pain? Do you feel pain shooting up your leg when you step or walk? Or do you feel a stabbing ache in your heel? Many of these pain issue people are dealing with correlate with plantar fasciitis. Studies reveal that plantar fasciitis results from degenerative irritation on the plantar fascia and its ligaments. This causes the muscle ligaments to become inflamed, swollen, and weak, which then causes the bottom of the foot or heel to hurt when a person is walking or standing. To that point, when there is a repetitive strain on the feet, it causes microtears in the plantar fascia. The plantar fascia in the foot plays an important role as it comprises three segments that support the medial arch and shock absorption when stepping down. As one of the most common causes of heel pain, the residual pain from plantar fasciitis tends to be a sharp, stabbing sensation. Plantar fasciitis is more prominent in middle-aged people. Still, anyone at any age can develop plantar fasciitis, especially if they have labor jobs requiring them to be constantly on their feet.

Symptoms Of Plantar Fasciitis

Since around 2 million Americans could potentially develop plantar fasciitis, it is important to know that when a person has been on their feet constantly, there will be inflammation along the tissues in the feet. Many individuals with a busy lifestyle that requires them to be on their feet frequently would often ignore the pain or discomfort. Some of the symptoms that plantar fasciitis causes include the following:

• Pain on the bottom of the heel
• Pain in the arch 
• Pain that is usually worse when waking up
• Pain that increases over months
• Swelling on the bottom of the heel

However, when the pain becomes overbearing, many people would often think they have sore feet or low back pain from being overly tired from work, under constant stress, or over-exerting their bodies. When this happens, many would think the pain would go away in a few days after resting for a short period.

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*