Posture Insights

The oblique muscles support and aid in side-to-side movement, helping maintain back strength and healthy posture. There are two oblique muscle sets, the internal and external obliques. Maintaining a strong core is one recommended way to protect the body and spine. However, many forget to train and strengthen all of the oblique muscles. Individuals tend to focus on the superficial core muscle, or rectus abdominis, and not enough or any attention goes to the lateral stabilizers or the internal and external obliques. Chiropractic and functional medicine can restore musculoskeletal flexibility, mobility, and function.

Oblique Muscles

The external obliques make up a large part of the trunk area. There are two external obliques on either side of the body, located on the lateral sides of the abdominal region. These muscles have an essential role in daily movements.

External

• External obliques help with trunk rotation and support spine rotation.
• They assist with pulling the chest down to compress the abdominal cavity.
• They help with bending from side to side.
• Any strain or injury to these muscles can lead to abdominal, hip, and back issues.
• Maximizing external oblique strength is important to maintain a strong core.

Internal

The internal oblique is a muscle deep within the lateral side of the abdomen.

• The internal oblique muscle is one of the main stabilizers and functions to flex the trunk and compress the chest.
• Its positioning makes it invisible, but it still has an essential role in body movement.
• This muscle can function bilaterally, meaning both sides can operate at the same time.
• These muscles provide spinal and posture support.
• Strain or injury in this area can cause posture problems and abdominal, hip, and back issues.

Rotation and Mobility

The internal and external obliques are the primary rotators of the spine and provide thoracic spine mobility.

• The internal obliques work with the external obliques and the rectus abdominis for lateral spine flexion of the quadratus lumborum and lumbar paraspinals.
• The internal obliques are part of the reflexive core stabilization system, responsible for maintaining intra-abdominal pressure or IAP.
• They attach to the diaphragm, transverse abdominis, and thoracolumbar fascia, contributing to core stabilization.
• A quadratus lumborum muscle spasm can result from muscle inhibition in the obliques.

Inhibition

If the internal obliques are inhibited, compensation can cause an alteration in the sequence patterns of the posterior oblique subsystem.

• When this system is not functioning correctly, individuals usually complain of discomfort in the hips and shoulders.
• A common sign of oblique inhibition is individuals holding their breath during basic movement patterns to gain stability, indicating dysfunction in the intrinsic stabilization subsystem.
• Simple movements include walking gait, single-leg stance, flexion, extension, etc.

Symptoms of Dysfunction

• Rounded shoulders
• Shoulder pain
• Flexion posture - Janda's upper-crossed syndrome.
• Internally rotated hips.
• Decreased hip extension.
• Knee instability and discomfort.
• Sacroiliac joint locking and soreness.
• Lower back discomfort and soreness.
• Lumbopelvic hip destabilization.
• Decreased ability in acceleration and deceleration when walking.

Dysfunction in one area leads to imbalances in other areas, affecting movement and causing impairment syndromes that can include:

• Muscle imbalances.
• Decreased stamina.
• Decreased strength.
• Increased fatigue.
• Central sensitization
• Increased stiffness and tightness in myofascial structures and kinetic chains.
• Increased risk of injury from unbalanced movement patterns and reaction times.

Chiropractic Reset

Chiropractic care, massage, and decompression therapy can restore body balance through:

• Soft-tissue release of the thoracolumbar fascia.
• Mobilization to subluxated areas of the thoracic spine, pelvis, and hips.
• Manual therapy
• Instrument-assisted soft-tissue release. 
• Muscle stimulation
• Laser therapy
• Ultrasound
• Corrective and strengthening exercises

Chiropractors and spinal rehabilitation specialists recommend specialized exercise regimens to target these muscles that include:

• Power Plate training
• Bodyweight exercises
• Yoga
• Pilates
• High-intensity interval training - HIIT

If you are experiencing waistline, hip, and low back stiffness or tightness and pain, consult our professional chiropractic team. We're ready to help!

Oblique Anatomy and Movement

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 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*

References

Calais-Germain, Blandine, and Stephen Anderson. Anatomy of Movement. Seattle: Eastland, 1993.

Cook G. Movement: Functional Movement Systems: Screening, Assessment, and Corrective Strategies. Aptos, CA: On Target Publications, 2010.

Elphinston J. Stability, Sport and Performance Movement: Practical Biomechanics and Systematic Training for Movement Efficacy and Injury Prevention. Lotus Publishing, 2013.

Huxel Bliven, Kellie C, and Barton E Anderson. "Core stability training for injury prevention." Sports health vol. 5,6 (2013): 514-22. doi:10.1177/1941738113481200

Myers TW. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Edinburgh: Churchill Livingstone, 2001.

Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation. St. Louis: Mosby, 2002.

Starrett K, Cordoza G. Becoming a Supple Leopard: The Ultimate Guide to Resolving Pain, Preventing Injury, and Optimizing Athletic Performance. Las Vegas: Victory Belt Pub., 2013.

Weinstock D. NeuroKinetic Therapy: An Innovative Approach to Manual Muscle Testing. Berkeley, CA: North Atlantic, 2010.

Introduction

The posterior section of the lower half of the body consists of the hips, low back, pelvis, legs, and feet, which provide stability to the body while supporting the upper body’s weight. The various muscles surround the lower extremities and make different motions for mobility and functionality by contracting and retracting when the legs and hips are in motion. The various muscles that provide stability to the hips and the legs are the iliopsoas muscles. When normal age or incidents affect the lower body extremities, it can correlate to the development of trigger point pain. Today’s article examines the iliopsoas muscles, how referred trigger pain affects the thighs and low back, and treating trigger point pain on the thighs and low back. We refer patients to certified providers who incorporate multiple techniques in the low back and thigh pain therapies related to trigger points to aid individuals dealing with pain symptoms along the iliopsoas muscle in the lower back, thigh, and near the pelvis. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

What Is The Iliopsoas Muscle?

Have you been dealing with muscle cramps in your thighs? What about feeling muscle stiffness in your lower back when you are stretching? Or do you feel your thigh muscles become heavy after a workout? Many of these issues correlate with the iliopsoas muscle becoming overused and developing trigger points, thus affecting the thighs and lower back. In the lower body extremities, the muscles that help provide stability to the hips are the iliopsoas muscles. The iliopsoas muscles consist of three muscles: iliacus, psoas major, and psoas minor, which can work individually or as a unit. When working individually, the iliacus muscle provides stability to the pelvis, the psoas major muscle helps stabilize the lumbar spine when a person is sitting, and the psoas minor helps with flexion of the trunk and stretch the iliac fascia. As a unit, however, these muscles work together to become the primary flexors of the thighs and allow hip flexion. 

Studies reveal that the iliopsoas is a deep muscle group that anatomically connects the spine to the body’s lower limbs. The iliopsoas muscles have an important function in the body’s lower limbs as primary hip flexors for daily activities, especially for those in sports. However, many impairments and pathologies affect the iliopsoas, which causes significant limitations and challenges since the symptoms mask the pain, causing individuals to think they are dealing with low back and hip pain. 

Referred Trigger Pain On The Thighs & Low Back

Since the iliopsoas muscles provide hip and thigh flexion to the lower body, many impairments and pathologies can affect this muscle group, causing issues in the hips, thighs, and even the lower back. These impairments can cause the iliopsoas muscles to be overused and overstretched, thus potentially developing trigger points along the iliopsoas muscles, causing referred pain on the thighs and low back. Studies reveal that when the iliopsoas muscle becomes overused or traumatic issues affect it, it can lead to problems in hip flexion and impairment in the lower extremities. In “Myofascial Pain and Disorders: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when trigger points begin to affect the iliopsoas muscles, it is known as the “Hidden Prankster” as normal factors like poor posture can overload the back causing trigger points to form not only on the iliopsoas muscles but the hamstrings, gluteal, thoracolumbar paraspinal, and posterior cervical muscles. Trigger points can mimic other chronic conditions that cause referred pain in different body areas. Trigger point pain in the iliopsoas muscle can lead to back pain, groin pain, snapping hips, and standing up difficult for the individual if it is not treated immediately.

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

As the “backbone” of the body, the thoracic region of the back has various muscles that help support the ribcage and protect the heart and lungs from injuries. The thoracic spine’s main function is providing respiration and maintaining good posture. However, various habits can cause issues to the muscles in the thoracic spine, which leads to upper back pain and the development of trigger points. One of the thoracic muscles affected by trigger points is the serratus posterior inferior muscle. Today’s article looks at the serratus posterior inferior muscle, how trigger points affect the thoracic region of the back, and how to manage thoracic back pain associated with trigger points. We refer patients to certified providers who provide different techniques in thoracic back pain therapies associated with trigger points to aid many suffering from pain-like symptoms along the serratus posterior inferior muscle along the back. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer

What Is The Serratus Posterior Inferior Muscle?

Have you felt aches and pain when bending down to pick something up? What about feeling tenderness near your lower back? Or have you experienced muscle stiffness when stretching? Many of these symptoms are associated with back pain that correlates to overusing the thoracic muscles, which includes the serratus inferior posterior muscles. The serratus posterior muscles (superior and inferior) are accessory breathing muscles as part of the extrinsic muscles. The serratus posterior inferior helps with the chest cavity’s expiration, while the superior help with inspiration. Some of the functionalities that the serratus posterior inferior provides are that in a bilateral action, the inferior works with the superior muscles to reduce the extension of the thoracic vertebrae.

In contrast, the unilateral action for the serratus posterior inferior muscle helps rotate the spine to the opposite sides. Studies reveal that based on the attachment of the serratus, the posterior inferior and superior are generally considered insignificant muscles. Since the serratus posterior muscles help aid respiration to the thoracic region, it can be succumbed to trigger points or myofascial pain syndrome that can affect the thoracic part of the back.

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 chest has the pectoralis major muscle that works with the upper half of the body that provides mobility and power. The pectoralis major also surrounds the clavicle skeletal structure and works with the thoracic spine. The chest allows mobility to the arms and stability to the shoulders while working together with the shoulder and arm muscles. Many individuals utilize the upper body more when working out, lifting, or carrying objects from one place to another. This causes the muscle to become overused and succumb to injuries that can affect the functionality of the chest and invoke pain-like symptoms in the body. One of the chest muscles affected by pain is the pectoralis muscles, especially the pectoralis minor muscle. Today’s article looks at the pectoralis minor muscle, how myofascial pain affects the pectoralis minor, and how to manage myofascial pain associated with the pectoralis minor. We refer patients to certified providers specializing in chest pain therapies to aid many people suffering from trigger point pain affecting the minor muscles of the pectoralis. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer

The Pectoralis Minor Muscle

Have you been experiencing pain in your upper-mid back? Do you feel like your chest is feeling compressed constantly? Do you feel the tension in your shoulders that makes it difficult to reach behind your back? Most of these symptoms are signs that many individuals are developing myofascial pain along the pectoralis muscles, especially the pectoralis minor. The pectoralis minor muscle is a thin triangular-shaped muscle below the pectoralis major. It has a crucial part of the chest as it helps stabilize the scapula (the shoulder blades) and is in front of the thoracic wall of the spine. The pectoralis minor is also part of the respiratory muscle group that works with the lungs. The pectoralis minor muscle has many functions for the shoulder blades, which include:

• Stabilization
• Depression
• Abduction or Protraction
• Internal Rotation
• Downwards Rotation

When environmental factors begin to affect the lungs and cause respiratory issues in the body, the surrounding respiratory muscle group also gets involved, causing the body to be hunched over.

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*

Look how young children position their backs. There is a natural S curve, and their movements are effortless. As the body ages, too much sitting, slouching, and inactivity can cause muscle fatigue and tension leading to posture issues. Rounded shoulders describe a resting position that has shifted the shoulders out of the body’s natural alignment, which can worsen if left untreated. Chiropractic care can realign the shoulders, as well as the spine, and restore musculoskeletal health to optimum levels.

Rounded Shoulders

Rounded shoulders are an excessive thoracic kyphosis referring to an uneven forward rounding or curvature of the middle and upper back. Rounded shoulders shift out of proper alignment with the spine, causing posture-related problems like shoulder/neck/back discomfort, tightness, stiffness, and pain. Overall unhealthy posture contributes to the following:

• The head constantly being in a forward or backward position
• Headaches
• Body aches and pains
• Muscle fatigue
• Chronic back soreness
• Bent knees when standing or walking
• Body movement dysfunction
• Joint problems
• Potbelly
• Rounded shoulders

Body responses to rounded shoulders include:

• Chronic musculoskeletal aches and pains
• Breathing problems
• Limited body function
• Impaired mobility performance
• Increased mental and musculoskeletal stress

Causes

Rounded shoulders are typically caused by unhealthy posture, but can also be caused by muscle imbalances from, for example, overfocusing on building chest strength but neglecting the core and upper back. Other causes include:

• Standing and sitting for long periods
• Stress
• Lack of physical activity
• Environmental factors
• Too much exercise, sports, and physical activities

Musculoskeletal Imbalance

Postural imbalances anywhere in the body can cause rounded shoulders.

• For example, when an individual tilts their head forward to look at their phone, the upper back has to round forward to hold the head. Constantly tilting can begin to generate an unhealthy muscle memory causing the neck and shoulder muscles to remain in a semi-flexed position that starts to become the norm.
• Another example is when the arms are held out and in front for prolonged periods, like driving, typing, and cooking, the chest muscles get shortened. As time goes on, this causes the shoulder blades to move forward on the ribcage, making the upper back and shoulder area hunch awkwardly and unhealthily.

Stress

When the brain perceives a threat, the body physically prepares to take action through the fight or flight response. Common reactions include:

• Jaw tensing
• Tightening the abdominal muscles
• Holding one’s breath
• Rounding the shoulders

Stressors can include:

• Job worries
• Money issues
• Relationship problems
• Family responsibilities
• All can cause changes in the body that result in rounded shoulders.

Environmental Factors

• Respiratory conditions like asthma, COPD, and allergies can affect the body’s breathing and the ability of the diaphragm to contract and relax correctly.
• Ribcage restrictions caused by chronic breathing problems can result in the thoracic/middle back tightening up, causing excessive shoulder rounding.

Exercise and Physical Activities

• Exercise and physical activities can contribute to rounded shoulders because of the long periods of spinal flexion. These can include:
• Bike riding, martial arts, and swimming. 
• Knitting requires the arms to be out in front.
• Gardening requires kneeling and being hunched over.

Chiropractic Treatment

Chiropractic adjustments, therapeutic massage, and decompression therapy can unlock tight shoulder and chest muscles. A chiropractor uses gentle targeted adjustments to relieve pain, restore function, and retrain the muscles.

• The doctor will look at the individual’s resting position while standing.
• An individual with slumped shoulders can slouch, even when standing up straight.
• Their hands will likely face behind them, with their thumbs pointed at each other.
• Once the adjustments are made, a correct standing posture will make the hands face the body with the thumbs facing ahead.
• Exercises will be recommended to strengthen the core and stretches to maintain the adjustments.

Posture 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 your own 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 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*

References

Fathollahnejad, Kiana, et al. “The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study.” BMC musculoskeletal disorders vol. 20,1 86. 18 Feb. 2019, doi:10.1186/s12891-019-2438-y

Go, Seong-Uk, and Byoung-Hee Lee. “Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers.” Journal of physical therapy science vol. 28,11 (2016): 2999-3002. doi:10.1589/jpts.28.2999

Kwon, Jung Won, et al. “Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders.” Journal of physical therapy science vol. 27,6 (2015): 1739-42. doi:10.1589/jpts.27.1739

Lee, Do Youn, et al. “Changes in rounded shoulder and forward head posture according to exercise methods.” Journal of physical therapy science vol. 29,10 (2017): 1824-1827. doi:10.1589/jpts.29.1824

Park, Sang-In, et al. “Effects of shoulder stabilization exercise on pain and functional recovery of shoulder impingement syndrome patients.” Journal of physical therapy science vol. 25,11 (2013): 1359-62. doi:10.1589/jpts.25.1359

The body is designed to move. For individuals who spend a significant amount of time driving each day, whether for a living or a long commute, over time can lead to headaches, neck and back pain, sciatica, and increases the risk for serious injury. Chiropractic can retrain individuals to practice healthy driving posture. This is accomplished through decompression and massage therapy combined with recommended stretches/exercises, and an anti-inflammatory diet will bring pain relief and help prevent injury.

Healthy Driving Posture

Two main reasons driving impacts the back are poor posture and being in a fixed position for an extended period. Individuals who regularly drive for more than 4 hours a day are more at risk. An unhealthy driving posture can lead to an increased risk of discomfort/pain in the:

• Neck
• Shoulders
• Arms
• Wrists
• Fingers
• Back
• Legs
• Feet
• Over time these issues can become chronic, making the body vulnerable to various injuries.

Back Pain Symptoms

Sometimes back pain needs immediate medical attention if any of the following symptoms present:

• Inflammation in the back.
• Swelling on the back.
• Constant pain does not go away or ease up after resting or movement.
• Pain in the upper back that radiates to the chest.
• A high temperature.
• Unexplained weight loss.
• Loss of bladder or bowel control.
• Numbness or tingling around the buttocks or groin area.

Driving Recommendations

Spine Support

• Slide the tailbone as close to the back of the seat as possible.
• Leave a gap between the back of the knees and the front of the seat.
• If the vehicle doesn't allow for the proper position, a back support cushion can help.

Raise The Hips

• If possible, adjust the area you sit on, so the thighs are supported along their entire length.
• The knees should be slightly lower than the hips.
• This will increase circulation to the back muscles while opening up the hips.

Sitting Too Close

• An individual should be able to comfortably reach the pedals and depress them through their full range with the entire foot.
• A safety study found that drivers whose chests were closer to the wheel were significantly more likely to suffer head, neck, and chest injuries in front and rear-end collisions.

Proper Height

• Ensure the seat raises the eye level a few inches above the steering wheel to allow sufficient clearance between the head and roof.

Seat Angle

• The angle of the back of the seat should go a little beyond 90 degrees to 100-110 degrees places minimal pressure on the back.
• Leaning too far back forces the individual to raise/push their head and neck forward, which can cause neck pain, shoulder pain, and tingling in the fingers.

Headrest Height

• The top of the headrest should be between the top of the ears and the top of the head.
• It should slightly touch the back of the head when sitting with a healthy driving posture.
• The headrest is vital in reducing whiplash injuries in the event of a rear-end collision.

Mirror Adjustments

• Ensure the rear-view and side mirrors are correctly adjusted will prevent straining the neck.
• Individuals should be able to see the traffic behind them without having to crane their necks.

Be Sure To Take Breaks

• Even with a healthy driving posture, fatigue can and will set in.
• Listen to your body and take breaks.
• Park in a safe place at a rest stop or designated area to get out of the vehicle, move around, and stretch.

Driving Posture Exercises

The following exercises can help improve driving posture and prevent pain while making deliveries or transporting people.

Shoulder Blade Squeeze

This exercise helps reduce pressure on the neck and shoulders.

• Bring the shoulder blades back and up with the hands on the steering wheel.
• Squeeze your shoulder blades together in the middle of the back.
• Hold for 3 seconds, then release.
• Repeat ten times.

Seated Pelvic Tilt

This exercise activates the abdominal and external oblique muscles.

• Press the lower back into the car seat.
• Inhale and tilt the pelvis forward to create an arch in the lower back.
• Hold for 3 seconds, then release.
• Repeat ten times.

Posture is more than just how one carries themselves. The effects of unhealthy posture can carry over into an individual's physical, mental, and emotional health. Whether it's caused by injury, stress, work, or sports, a professional chiropractor will help you get back to optimal health.

Driving Position

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make your own 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 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*

References

Cvetkovic, Marko M et al. "Assessing Post-Driving Discomfort and Its Influence on Gait Patterns." Sensors (Basel, Switzerland) vol. 21,24 8492. 20 Dec. 2021, doi:10.3390/s21248492

Pope, Malcolm H et al. "Spine ergonomics." Annual review of biomedical engineering vol. 4 (2002): 49-68. doi:10.1146/annurev.bioeng.4.092101.122107

Tinitali, Sarah, et al. "Sitting Posture During Occupational Driving Causes Low Back Pain; Evidence-Based Position or Dogma? A Systematic Review." Human factors vol. 63,1 (2021): 111-123. doi:10.1177/0018720819871730

van Veen, Sigrid, and Peter Vink. "Posture variation in a car within the restrictions of the driving task." Work (Reading, Mass.) vol. 54,4 (2016): 887-94. doi:10.3233/WOR-162359

The ribs are designed to protect the lungs and heart and assist breathing. Twenty-four ribs start at the shoulders in the thoracic spine region and run down the mid-back covering the front, back, and side of the chest. Almost all ribs are attached in two places, including the spine in the back and the sternum in the front of the chest, by cartilage joints. Trauma, poor posture, intense coughing, sneezing, and heaving are a few factors that can cause mechanical rib dysfunction or rib misalignment and where they are attached to.

Rib dysfunction and misalignment are typically caused by unhealthy postures like slumped back and rounded shoulders, weakened posterior muscles, and repetitive stress from work, sports, and intense physical activity. Any ribs can become misaligned, causing dysfunction and stress on the body. A chiropractor can adjust and reset the rib as they do for misaligned and compressed spinal joints.

Rib Cage Design

The ribcage is flexible and expands when inhaling. Each rib is attached to the spine by three joints in the back and the breastbone in the front. Breathing is an involuntary reflex that is impossible to avoid movement in these joints. The joints are small but allow flexing, so the ribs rise and fall with each breath. These rib joints can become inflamed from rib misalignment causing movement problems that can restrict breathing.

Rib Misalignment

Rib misalignment symptoms can include:

• Difficulty breathing.
• Difficulty when trying to sit up.
• Dull, achy, deep pain next to the spine or under the shoulder blade.
• Unexplained back pain.
• Pain when moving or walking.
• Painful sneezing and/or coughing.
• Tenderness and pain in the front of the chest.
• The formation of a lump over the affected rib.
• Swelling and/or bruising in the region.
• Numbness in nearby or surrounding ribs.
• Radiating pain from the back to the front and vice versa.
• Improvement when pressure is applied to the affected rib.

Rib Dysfunction

Up to 50% of emergency room visits for chest pain symptoms result from non-cardiac factors, with the majority being rib misalignment and the muscles and joints around the rib cage becoming irritated/inflamed.

Causes

There can be several reasons for a misaligned rib. The more common causes include:

Unhealthy Postures

• Unhealthy postures stress the body that can place pressure on the posterior portion of the ribcage.
• With time, the ribs can start to shift out of alignment.

Physical Activity, Exercise, and Sports

• Working out intensely can cause the ribs to shift out of position.
• Weight lifting improperly can cause the body to shift along with the muscles involved not being strong enough to handle the added weight and movement, causing rib misalignment.

Pregnancy

• As a woman's body changes, the weight shifts to the front.
• This can create a downward pull on the rib cage, increasing misalignment risk.

Intense Coughing or Sneezing 

• Excessive or severe coughing, associated with asthma, bronchitis, or pneumonia, can significantly strain the ribcage.
• Coughing from a common cold can generate stress to cause a rib to dislocate.
• Sneezing hard can also cause a rib to shift out of place.
• Illnesses associated with constant coughing and sneezing can increase an individual's susceptibility to rib misalignment because of the weakened state of the muscles.

Intense Vomiting

• Vomiting intensely or heaving can cause the condition.
• Vomiting does not necessarily involve the lungs, but the convulsive action can cause a rib shift/pop out.

Chiropractic Treatment

Chiropractic can diagnose and treat rib misalignment/dysfunction by using various stretching or massage techniques to loosen the area, making the muscles more flexible, then applying firm pressure to realign the rib back. The treatment plan will include specific stretches, postural exercises, diet, and other recommendations to prevent rib problems.

Spinal Decompression In 90 Seconds

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care 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 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*

References

Flodine TE, Thomas M. Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction. [Updated 2021 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560751/

Jawed, Muzamil. and Bruno Bordoni. “Osteopathic Manipulative Treatment: Muscle Energy Procedure - Exhaled Ribs.” StatPearls, StatPearls Publishing, 19 February 2022.

Rib somatic dysfunction (417242001); Costal somatic dysfunction (417242001); Somatic dysfunction of rib (417242001) https://www.ncbi.nlm.nih.gov/medgen/736159

Vemuri, Adithi. and Kiyomi K. Goto. “Osteopathic Manipulative Treatment: Counterstrain/FPR Procedure - Thoracic Vertebrae.” StatPearls, StatPearls Publishing, 15 November 2021.

Back pain for no reason that is non-specific is also known as idiopathic, meaning there is no definitive cause like a herniated disc, vehicle accident/crash, falling accident, work, school, or sports injury. An aching sore back that came out of nowhere can be baffling. However, there are reasons for pain, including age, unhealthy posture, work occupation, muscle spasms, lifestyle habits, family medical history, and viscerosomatic reflexes.

Back Pain No Reason

Individuals will trace back their steps and often find that there was no heavy lifting of packages, overdoing it working out, or bending, twisting awkwardly, but the pain is present. 

Age

• Age is a primary cause of back pain. After the age of 20, the discs in the spine begin to dehydrate, shrink, and compress/flatten out. This can cause everyday activities to generate back strain and pain as the discs begin to slip, slide, and rub against each other. This is known as degenerative disc disease and is a process that continues as the body gets older.

Back Muscle Spasms

• Muscle spasms are a common manifestation of back pain and occur when the muscles involuntarily contract. Spasms often happen from bending, heavy lifting, or other physical activities.

Lifestyle Factors

Lifestyle factors can be a causation factor for back pain that comes out of nowhere.

• Smoking increases the risk as nicotine increases the wear and tear on the discs as well as other organs.
• The smoke/nicotine causes the discs to age faster because it breaks down the collagen, an essential part of the discs.
• Individuals that are out of shape, overweight, and/or obese are more likely to have back pain from the added weight.

Unhealthy Posture/Mechanics

• Practicing unhealthy postures will no doubt begin to cause back or some type of pain from the strain and awkward positioning placed on the muscles being used. Strains, twists, pulls, or tears can occur if repeating the same motion.

Viscerosomatic Reflex

• Viscera means organ, and somatic refers to the body or musculoskeletal system. A viscerosomatic reaction happens when a pain signal from an organ is transmitted via the spinal cord, where neurons and motor structures like the muscles, blood vessels, and skin are interconnected. The body's organs can become distressed or suffer an infection/disease that causes signals to be sent that there is something wrong. However, the signal could be pain that materializes in the spine/back muscles but is not a spinal injury or condition.

Diagnosis and Treatment

The first step to successfully treating back pain is scheduling an appointment with a spine specialist or chiropractor. A series of specific questions will be asked to gain insight into the underlying cause of the pain. These include:

• Location of the pain
• The intensity of the pain
• Frequency of the pain
• Medical history
• Diet habits

A careful examination is necessary for the doctor to identify the reasons in any individual patient. Once the physician has learned about the symptoms and history, they can determine a possible cause and create a personalized treatment/rehabilitation plan to get the body back to optimal health.

Decompression Patient Testimonials

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own 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 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*

References

Koes, B W et al. "Diagnosis and treatment of low back pain." BMJ (Clinical research ed.) vol. 332,7555 (2006): 1430-4. doi:10.1136/bmj.332.7555.1430

Lankhorst, G J et al. "The natural history of idiopathic low back pain. A three-year follow-up study of spinal motion, pain and functional capacity." Scandinavian journal of rehabilitation medicine vol. 17,1 (1985): 1-4.

https://www.niams.nih.gov/health-topics/sports-injuries

Walker, Bruce F et al. "Combined chiropractic interventions for low-back pain." The Cochrane database of systematic reviews vol. 2010,4 CD005427. 14 Apr. 2010, doi:10.1002/14651858.CD005427.pub2

Healthy hips are necessary for standing, sitting, walking, running, bending, twisting, lifting, etc. Hip problems can seriously interfere with everyday activities. Out of alignment hips don’t just cause pain and soreness in the hip area but can radiate to other body areas. When the hip joint is out of alignment, the rest of the body has to start compensating for the misalignment, which can cause chronic pain in the back and/or legs.

Out of Alignment Hips

Discomfort and soreness begin as occasional but can quickly become regular. Individuals may also begin to limp when they walk, have a reduced range of motion in the hips, and pain that escalates with physical activity and improves with immobility/rest. Out of alignment hips can be caused by:

• Lifting incorrectly
• Repetitively carrying heavy loads on one side of the body places uneven pressure on the pelvis, causing an imbalance.
• Performing repetitive motions that begin to stress the joint
• Wearing shoes that do not provide proper support
• Standing and leaning on one leg regularly
• Injury/trauma
• Physical leg length discrepancy
• Functional leg length discrepancy
• Scoliosis

Physical Leg Length Discrepancy

If the legs are different lengths, this can cause the hips to go out of alignment. Using a foot wedge/foot orthotic in the shoe can remedy the situation.

Functional Leg Length Discrepancy

Functional leg length discrepancy is a common cause of hip misalignment, meaning that leg length is equal, but the individual is doing something to cause the hips to go out of alignment. It usually involves posture, standing, walking, sitting, lifting, and carrying improperly or awkwardly and repetitively could create functional leg length discrepancy.

Scoliosis

Scoliosis is only one cause of hip misalignment. It is not likely that an individual has scoliosis if they are an adult and have not previously been diagnosed with the condition. If a child has what looks like a misaligned hip, it is recommended to take them to get tested for scoliosis. Most children with the disorder will outgrow it, but they need to be monitored by a medical professional.

Symptoms include:

• Uneven gait
• Uneven shoulders
• Hip pain on one side
• Groin pain
• Tight buttock muscles
• Tight leg muscles
• Back pain - upper and lower
• Sciatica
• Knee pain
• Ankle pain

One of the most prominent signs that it is a hip problem is the presence of groin pain. Groin pain can radiate downward toward the buttocks, front of the thighs, and knees. The hip joint is located behind the groin; pain usually means the hip is the root cause.

Chiropractic Decompression

A chiropractic examination can identify uneven hips. Chiropractic and motorized spinal decompression can reset the hips to their proper position. A chiropractor will be able to rebalance the hips and help avoid invasive surgical treatments and long-term rehabilitation.

DRX9000 90 Seconds Spinal Decompression

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own 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 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*

References

Battaglia, Patrick J et al. “Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging.” Journal of chiropractic medicine vol. 15,4 (2016): 281-293. doi:10.1016/j.jcm.2016.08.004

Jones HR, Burns TM, Aminoff MJ, Pomeroy SL. Pain. Chapter: Diagnosis of Low Back, Buttock, and Hip Pain. Netter Collection of Medical Illustrations: Spinal Cord and Peripheral Motor and Sensory Systems, Section 8, 201-224.

Khamis, Sam, and Eli Carmeli. “A new concept for measuring leg length discrepancy.” Journal of orthopedics vol. 14,2 276-280. 27 Mar. 2017, doi:10.1016/j.jor.2017.03.008

Miyagi, Masayuki, et al. “Hip-spine syndrome: cross-sectional-study of spinal alignment in patients with coxalgia.” Hip international: the journal of clinical and experimental research on hip pathology and therapy vol. 29,1 (2019): 21-25. doi:10.1177/1120700018803236

Nunes, Guilherme S et al. “Acute Effects of Hip Mobilization With Movement Technique on Pain and Biomechanics in Females With Patellofemoral Pain: A Randomized, Placebo-Controlled Trial.” Journal of sport rehabilitation vol. 29,6 707-715. 18 Oct. 2019, doi:10.1123/jsr.2018-0497

As the body gets older, slouching, little to no physical activity, and regular stretching cause muscle fatigue, weakness, tension, leading to poor posture complications. The complications include:

• Back and neck pain
• Rounded shoulders
• Spinal dysfunction
• Joint degeneration
• Sleep problems
• Chronic pain

Posture can be improved along with overall spinal health and a better quality of life through chiropractic treatment. Chiropractic will improve posture through adjustments, postural exercise training and stretching, education on ergonomics, and nutrition to strengthen the body.

Complications Poor Posture

Symptoms

Symptoms vary as they depend on the severity of the case and condition.

• Muscle fatigue/weakness
• Body aches and soreness
• Back pain
• Rounded shoulders
• Standing and/or walking problems
• Headaches
• Potbelly

Mechanisms

Poor posture leads to dysfunction and interference with the body's postural mechanisms. These include:

• Slow-twitch and fast-twitch muscle fibers
• Muscle strength and length
• Body positioning nervous system feedback.

Muscle Fibers

Skeletal muscle comprises two types of muscle fiber. They are static or slow-twitch muscles and phasic or fast-twitch muscles. Static muscle fibers are found in the deeper muscle layers. Static fibers burn energy slowly and keep working without tiring. They help the body maintain posture without effort and contribute to balance by sensing the body's position and transmitting the information to the brain. Phasic muscle fibers are used for movement and activity but can quickly run out of energy. Poor posture causes muscle fatigue because the phasic fibers are used rather than the static fibers to maintain the body's proper position.

Muscle Strength and Length

Over time, the body constantly needs support from the phasic muscle fibers. This causes the deeper supporting muscles to waste away because they are not being used. Weak, unused muscles begin to tighten, causing a shortening of muscle length that can compact the spine's bones and cause back complications.

Nervous System Feedback

The deeper layers of muscle sense the body's position in space and relay this information to the brain. The brain does not receive complete transmission if the phasic muscle fibers take over this function. The brain assumes that the body needs to be propped up/corrected to counteract the poor posture effects, triggering further muscle contraction, adding to the fatigue and pain.

Listening To The Body

The objective is to form a habit of regularly listening to what the body is saying. Make minor adjustments while standing and sitting throughout the day/night. Often what happens is individuals become so immersed in their work, school tasks that they ignore any physical discomfort and push through and forget to change positions/move around to get the muscles moving and the blood pumping. If there is muscle tension or fatigue, don't just work through the pain; move into another healthy position.

Posture Improvement

Suggestions include:

• Try to avoid sitting in soft chairs.
• Switch to ergonomic chairs for any activity that requires sitting for long periods.
• Use a lumbar roll to support the lower back when sitting in regular chairs or driving.
• Remember to reverse the curve; an example could be if leaning over a desk/workstation, stretch the back in the other direction.
• Get into stretching exercises to increase muscle flexibility.
• Strength train to improve muscle strength and tone.
• Avoid standing for long periods.
• Use a posture app.

Body Composition

Strength Training

As the body ages, it loses muscle mass, known as sarcopenia. Between the ages of 30 and 80, both men and women can lose 30-50 percent of their muscle strength. Decreasing strength can make it a challenge to lead an active lifestyle or have energy levels to complete the daily errands. Individuals can be reluctant to improve fitness levels through resistance workouts believing there is nothing left after years of inactivity. This is not true as anybody can strength train. With the right mindset, and health coaching team, goals can be set to:

• Improve body composition
• Improve energy levels
• Maintain an active lifestyle

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 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 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*

References

Creze, Maud et al. "Posture-related stiffness mapping of paraspinal muscles." Journal of anatomy vol. 234,6 (2019): 787-799. doi:10.1111/joa.12978

Deliagina, Tatiana G et al. "Physiological and circuit mechanisms of postural control." Current opinion in neurobiology vol. 22,4 (2012): 646-52. doi:10.1016/j.conb.2012.03.002

Korakakis, Vasileios et al. "Physiotherapist perceptions of optimal sitting and standing posture." Musculoskeletal Science & practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004

Pollock, A S et al. "What is balance?." Clinical rehabilitation vol. 14,4 (2000): 402-6. doi:10.1191/0269215500cr342oa

Waters, Thomas R, and Robert B Dick. "Evidence of health risks associated with prolonged standing at work and intervention effectiveness." Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses vol. 40,3 (2015): 148-65. doi:10.1002/rnj.166

Improving posture can be challenging. Poor posture is often the source of various musculoskeletal issues like chronic pain throughout the body. Poor posture can be so ingrained in the brain that it becomes an unconscious positioning reflex that feels right but could be worsening spinal, hip, and leg problems. The Alexander Technique could be a treatment option that could help long-term.

Alexander Technique

The approach focuses on learning mind-body awareness. It is an educational process to teach individuals to become aware of their body positioning and change unhealthy posture/movement habits into healthy ones. The objective is learning to utilize sufficient levels of muscle tension for everyday activities, like sitting, standing up, and walking in a healthy way to maintain optimal health of the musculoskeletal system.

• The theory is that less tension minimizes wear and tear on the muscles and structures of the spine vulnerable to compression.
• The fundamental goal of the Alexander Technique is to undo all the unhealthy tension habits to decompress the spine and retrain the mind and body to approach movement and body positioning in a new and healthy way.

Teachings

The technique can be done in a class setting or one-on-one teaching because everyone's postural and movement habits are unique. A teacher helps identify the tension-inducing postures and educates the individual on how to correct them. Human touch is an integral part of the Alexander Technique. Using their hands gently to adjust the individual to a proper upright position, a teacher helps release pressure from the head, neck, shoulders, and upper back.

The individual learns to release the tension throughout their body. The Alexander Technique is a type of hands-on therapy; it is not manipulation or massage. It uses a light touch with no risk of injury to the spine, allowing anyone to participate. However, individuals must be willing to participate/engage in the process to get the benefits. Most individuals can tell if it's right for them during the first lesson. A typical program teaches:

• Comfortably sitting up straight.
• Reducing overuse of superficial musculature.
• Increasing proprioceptive awareness.
• Staying alert to the body's warning of tension and compression.

Tension Build Up

Individuals usually don't even realize they're constantly placing pressure on their spine from unhealthy postural habits, building up muscular tension they never knew they created. For example, unhealthy neck position habits include:

• Pushing the head forward
• Slumping over
• Pinning the shoulders back
• These postures generate/build pressure and tension that radiates outward and down to the large muscles of the spine.
• Habitual downward pressure can pull and change the spine's shape, leading to degenerative forms of spinal deformity in severe cases.
• When the tension is released, the neck and body begin to stand upright comfortably, without pulling down or pulling back.

Frederick Matthias Alexander

Developed the technique in the 1890s to help his muscle tension problems affecting his acting career. When performing, he would stiffen his neck and pull his head back and up, building tension that caused him to tighten his throat and lose his voice. He did not know he was doing this until he performed in front of a mirror and saw his awkward positioning.

He realized this and retrained himself to pose naturally, stay relaxed, and be aware of any tension building in the muscles to release it immediately. Alexander Technique educators/practitioners practice all over the world. 

The American Society for the Alexander Technique or AmSAT website has a Find A Teacher Tool that connects individuals to AmSAT-approved teachers.

Body Composition

Practicing Mindfulness

Developing a mindfulness practice can help identify triggers of negative behavior or thoughts. Just like diet and exercise, practicing mindfulness is unique to everyone. It is recommended to try different things like:

• A five-minute guided meditation.
• Journaling.
• Mindful music listening.

• Journaling is another way to tune into oneself. Grab a pen and paper, a computer, tablet, or phone, and take a few minutes to write every day.
• Write one thing that makes you happy.
• One thing you want to improve.
• One goal you want to accomplish that day or that week.

Mindful music listening can help reduce stress by allowing the individual to focus their attention when their mind is going in all directions.

• Instead of turning to the news or email when waking up, grab a cup of coffee or tea and listen to a favorite podcast or music.
• Put the phone away and listen to your mind and self.

Try to meditate in the morning when waking up. This helps set the day's goals/plans. Goal-setting mindfulness has been shown to reduce stress levels and anxiety. However, if the morning is not possible then at night before bed can be used to reflect on the day's activities, what went well, what didn't, how to improve something, whatever the case, the point is to make time for yourself to reflect, set goals, and develop a plan to achieve those goals.

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*

References

Becker, Jordan J et al. "Preliminary evidence for feasibility, efficacy, and mechanisms of Alexander technique group classes for chronic neck pain." Complementary therapies in medicine vol. 39 (2018): 80-86. doi:10.1016/j.ctim.2018.05.012

Cacciatore et al., Improvement in automatic postural coordination following Alexander technique lessons in a person with low back pain. Physical Therapy Journal, 2005; 85:565-578. Accessed January 5, 2011

Chin, Brian et al. "Psychological mechanisms driving stress resilience in mindfulness training: A randomized controlled trial." Health psychology: official journal of the Division of Health Psychology, American Psychological Association vol. 38,8 (2019): 759-768. doi:10.1037/hea0000763

Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. The BMJ. 2008;337:a884. doi: https://doi.org/10.1136/bmj.a884.

Paolucci, Teresa et al. "Chronic low back pain and postural rehabilitation exercise: a literature review." Journal of pain research vol. 12 95-107. December 20 2018, doi:10.2147/JPR.S171729

Musculoskeletal Disorders, or MSDs, are injuries, conditions, and disorders that affect the body's musculoskeletal system. It includes the muscles, tendons, ligaments, nerves, discs, blood vessels, bones, and joints. MSDs are common, and the risk of developing them increases with age. The severity of an MSD can vary. They cause discomfort, recurrent pain, stiffness, swelling, and aching that interfere with everyday activities. Early diagnosis and treatment can alleviate symptoms and improve long-term health. Common disorders include:

• Tendonitis
• Tendon Strain
• Epicondylitis
• Carpal Tunnel Syndrome
• Trigger Finger
• Radial Tunnel Syndrome
• DeQuervain's Syndrome
• Rotator Cuff Tendonitis
• Muscle strain
• Ligament Sprain
• Rheumatoid arthritis - RA
• Osteoarthritis
• Tension Neck Syndrome
• Thoracic Outlet Compression
• Mechanical Back Syndrome
• Degenerative Disc Disease
• Ruptured Disc
• Herniated Disc
• Fibromyalgia
• Digital Neuritis
• Bone Fractures

Musculoskeletal Disorders Discomfort and Pain

The term musculoskeletal disorder is used as it accurately describes the injury or condition. Other terms used are repetitive motion injury, repetitive stress injury, and overuse injury. When individuals are exposed to MSD risk factors, they begin to fatigue. This can start a musculoskeletal imbalance. With time, fatigue completely overtakes recovery/healing, and the musculoskeletal imbalance continues, a musculoskeletal disorder develops. The risk factors are broken into two categories: work-related/ergonomic risk factors and individual-related risk factors.

Ergonomic Factors:

• Force
• Repetition
• Posture

High Task Repetition

• Many work tasks and cycles are repetitive and are typically controlled by hourly or daily production targets and work processes.
• High task repetition combined with other risks factors like high force and/or awkward postures can contribute to the formation of MSD.
• A job is considered highly repetitive if the cycle time is 30 seconds or less.

Forceful Exertions

• Many job tasks require high force loads on the body.
• Muscle effort increases in response to high force requirements. This increases associated fatigue.

Repetitive or Sustained Awkward Postures

• Awkward postures place excessive force on joints, overload the muscles and tendons around affected joints.
• The joints of the body are most efficient when they operate close to the mid-range motion of the joint.
• The risk of MSD is increased when the joints are worked outside of this mid-range repetitively for sustained periods without a proper amount of recovery time.

Individual Factors

• Unhealthy work practices
• Lack of physical activity/fitness
• Unhealthy habits
• Poor diet

Unhealthy Work Practices

• Individuals that engage in poor work practices, body mechanics, and lifting techniques are introducing unnecessary risk factors.
• These poor practices create unnecessary stress on the body that increases fatigue and decreases the body's ability to recover properly.

Poor Health Habits

• Individuals who smoke, drink excessively, are obese, or exhibit numerous other poor health habits put themselves at risk for musculoskeletal disorders and other chronic diseases.

Insufficient Rest and Recovery

• Individuals that do not get adequate rest and recovery put themselves at higher risk.
• MSDs develop when fatigue outruns the individual's recovery system, causing a musculoskeletal imbalance.

Poor Diet, Fitness, and Hydration

• Individuals who eat unhealthily are dehydrated, at a poor level of physical fitness, and do not take care of their bodies are putting themselves at a higher risk of developing musculoskeletal and chronic health problems.

Causes

The causes of musculoskeletal disorders are varied. Muscle tissue can be damaged with the wear and tear of daily work, school, and physical activities. Trauma to the body can come from:

• Postural strain
• Repetitive movements
• Overuse
• Prolonged immobilization
• Jerking movements
• Sprains
• Dislocations
• Falling injuries
• Auto accident injuries
• Fractures
• Direct trauma to the muscle/s

Poor body mechanics can cause spinal alignment problems and muscle shortening, causing other muscles to be strained, causing problems and pain.

Treatment Rehabilitation

A doctor will recommend a treatment plan based on the diagnosis and severity of the symptoms. They may recommend moderate exercise and over-the-counter medications like ibuprofen or acetaminophen to address occasional discomfort or pain. They often recommend chiropractic and physical therapy rehabilitation to learn how to manage pain and discomfort, maintain strength, range of motion, and adjust everyday activities. Different types of manual therapy, or mobilization, can treat body alignment problems. A doctor may prescribe medications like nonsteroidal anti-inflammatories NSAIDs to reduce inflammation and pain for more severe symptoms. For individuals with musculoskeletal disorders like fibromyalgia, medications to increase the body's level of serotonin and norepinephrine may be prescribed in low doses to modulate sleep, pain, and immune system function.

Body Composition

Types of Pain

Pain can be grouped into three categories:

Early Warning Pain

• This is most recognizable after having just touched a pan, and the hand jerks away before realizing how hot the pan is, also known as the withdrawal reflex.
• This is a protective mechanism that helps avoid danger and is vital for survival.

Inflammatory Pain

• This type of pain happens after an injury or surgery while the body is healing and recovering.
• Inflammation prevents the body from performing movements to prevent and avoid re-injury.

Pathological Pain

• This type of pain can happen after the body has healed, but the nervous system has been damaged.
• This is often the case with individuals who sustain an injury and inform doctors that the injured area is never the same.
• If the rehabilitation does not correctly heal the nervous system, protective pain measures can generate a false alarm causing pain signals to fire off.

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*

References

Asada, Fuminari, and Kenichiro Takano. Nihon eiseigaku zasshi. Japanese journal of hygiene vol. 71,2 (2016): 111-8. doi:10.1265/jjh.71.111

da Costa, Bruno R, and Edgar Ramos Vieira. "Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies." American journal of industrial medicine vol. 53,3 (2010): 285-323. doi:10.1002/ajim.20750

Malińska, Marzena. “Dolegliwości układu mięśniowo-szkieletowego u operatorów komputerowych” [Musculoskeletal disorders among computer operators]. Medycyna pracy vol. 70,4 (2019): 511-521. doi:10.13075/mp.5893.00810

Musculoskeletal system diseases. (n.d.). dmu.edu/medterms/musculoskeletal-system/musculoskeletal-system-diseases/

Roquelaure, Yves et al. "Troubles musculo-squelettiques liés au travail" [Work-related musculoskeletal disorders]. La Revue du praticien vol. 68,1 (2018): 84-90.

Villa-Forte A. (n.d.). Diagnosis of musculoskeletal disorders. merckmanuals.com/home/bone,-joint,-and-muscle-disorders/diagnosis-of-musculoskeletal-disorders/introduction

Work-related musculoskeletal disorders (WMSDs). (2014). ccohs.ca/oshanswers/diseases/rmirsi.html

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

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