Mobility & Flexibility - Joint Movement

Can individuals with Ehlers-Danlos syndrome find relief through various non-surgical treatments to reduce joint instability?

Introduction

The joints and ligaments surrounding the musculoskeletal system allow the upper and lower extremities to stabilize the body and be mobile. The various muscles and soft connective tissues that surround the joints help protect them from injuries. When environmental factors or disorders start to affect the body, many people develop issues that cause overlapping risk profiles, which then affect the stability of the joints. One of the disorders that affect the joints and connective tissue is EDS or Ehlers-Danlos syndrome. This connective tissue disorder can cause the joints in the body to be hypermobile. It can cause joint instability in the upper and lower extremities, thus leaving the individual to be in constant pain. Today’s article focuses on Ehlers-Danlos syndrome and its symptoms and how there are non-surgical ways to manage this connective tissue disorder. We discuss with certified medical providers who consolidate our patients’ information to assess how Ehlers-Danlos syndrome can correlate with other musculoskeletal disorders. We also inform and guide patients on how various non-surgical treatments can help reduce pain-like symptoms and manage Ehlers-Danlos syndrome. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to manage the effects of Ehlers-Danlos syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

What Is Ehlers-Danlos Syndrome?

Do you often feel extremely tired throughout the day, even after a full night of sleep? Do you bruise easily and wonder where these bruises are coming from? Or have you noticed that you have an increased range in your joints? Many of these issues are often correlated with a disorder known as Ehlers-Danlos syndrome or EDS that affects their joints and connective tissue. EDS affects the connective tissues in the body. The connective tissues in the body help provide strength and elasticity to the skin, joints, as well as blood vessel walls, so when a person is dealing with EDS, it can cause a significant disruption to the musculoskeletal system. EDS is largely diagnosed clinically, and many doctors have identified that the gene coding of the collagen and proteins that interact in the body can help determine what type of EDS affects the individual. (Miklovic & Sieg, 2024)

The Symptoms

When understanding EDS, it is essential to know the complexities of this connective tissue disorder. EDS is classified into numerous types with distinct features and challenges that vary depending on the severity. One of the most common types of EDS is hypermobile Ehlers-Danlos syndrome. This type of EDS is characterized by general joint hypermobility, joint instability, and pain. Some of the symptoms that are associated with hypermobile EDS include subluxation, dislocations, and soft tissue injuries that are common and may occur spontaneously or with minimal trauma. (Hakim, 1993) This can often cause acute pain to the joints in the upper and lower extremities. With its broad range of symptoms and the personal nature of the condition itself, many often don’t realize that joint hypermobility is common in the general population and may present no complications that indicate that it is a connective tissue disorder. (Gensemer et al., 2021) Additionally, hypermobile EDS can lead to spinal deformity due to the hyperextensibility of the skin, joints, and various tissue fragility. The pathophysiology of spinal deformity associated with hypermobile EDS is primarily due to muscle hypotonia and ligament laxity. (Uehara et al., 2023) This causes many people to reduce their quality of life and daily living activities significantly. However, there are ways to manage EDS and its correlating symptoms to reduce joint instability.

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 shoulder and upper back pain, could periscapular bursitis be a possible cause?

Periscapular Bursitis

The scapula/shoulder blade is a bone that shifts position with upper body and shoulder movement. The scapula motion is critical to the normal function of the shoulder and the spine. When abnormal or sudden shoulder movements occur, inflammation and pain symptoms can develop. (Augustine H. Conduah et al., 2010)

Normal Scapula Function

The scapula is a triangular bone on the upper back outside the rib cage. Its outer or lateral side contains the shoulder joint socket /glenoid, while the rest of the bone serves as attachment points for the different shoulder and back muscles. The scapula shifts on the rib cage when moving the arm forward and back. This movement is called scapulothoracic motion and is critical to the normal function of the upper extremity and the shoulder joint. When the scapula does not glide in a coordinated motion, the function of the torso and shoulder joints can become stiff and painful. (J. E. Kuhn et al., 1998)

Scapular Bursa

A bursa is a fluid-filled sac that allows smooth, gliding motion between structures, body tissues, bones, and tendons. Bursae are found throughout the body, including those in front of the kneecap, outside the hip, and at the shoulder joint. When a bursa becomes inflamed and irritated, normal movements can become painful. There are bursae around the scapula in the upper back. Two of these bursa sacs are between the bones and the serratus anterior muscle that controls scapular movement on the chest wall. One bursa sac is located on the upper corner of the scapula, close to the spine at the base of the neck, and the other is at the bottom corner of the scapula, close to the mid-back. Either or both bursa sacs can be affected by periscapular bursitis. There are other bursae around the scapula and the surrounding tendons, but the two corner sacs tend to be the primary bursae that develop periscapular bursitis.

Inflammation

When these bursae become inflamed and irritated, swollen, and thickened, the condition known as bursitis results. When bursitis occurs near the scapula, muscle, and shoulder blade movements can lead to discomfort and pain. The most common symptoms of periscapular bursitis include:

• Snapping with movement
• Grinding sensations or crepitus
• Pain
• Tenderness directly over the bursa (Augustine H. Conduah et al., 2010)
• Abnormal scapular sensations and movements

An examination of the scapula may display abnormal movements of the shoulder blade. This can lead to winging, where the shoulder blade is not held correctly to the rib cage and protrudes abnormally. Individuals with winging of the scapula typically have abnormal shoulder joint mechanics because the shoulder's positioning is altered.

Causes

The causes of periscapular bursitis can be varied. The most common is overuse syndrome, where a specific activity is causing irritation to the bursa. These can include:

• Sports-related activities that result from repetitive use.
• Work-related activities that result from repetitive use.
• Traumatic injuries that cause inflammation or irritation to the bursa.

Some conditions can cause abnormal anatomy or bone protuberances, irritating the bursa. One condition is a benign bone growth known as an osteochondroma. (Antônio Marcelo Gonçalves de Souza and Rosalvo Zósimo Bispo Júnior 2014) These growths can project off the scapula, leading to irritation and inflammation.

Treatment

Treatment of periscapular bursitis begins with conservative therapies. Invasive treatments are rarely needed to correct the problem. Treatment can include:

Rest

• The first step is to rest the irritated bursa and settle the inflammation.
• This can take a few weeks and can be accomplished by modifying physical, sports, or work-related activities.

Ice

• Ice is useful for reducing inflammation and controlling pain.
• Knowing how to ice an injury properly can help manage the pain and swelling.

Physical Therapy

• Physical therapy can alleviate the symptoms of inflammation through various exercises and stretches.
• The therapy can improve scapular mechanics so the injury does not become ongoing and recurrent.
• Abnormal movement of the scapula on the rib cage can not only lead to the development of bursitis, but if these abnormal mechanics are not addressed, the problem may recur.

Anti-Inflammatory Medications

• Non-steroidal anti-inflammatory medications are used to control the inflammation in the short term. (Augustine H. Conduah et al., 2010)
• The medications can help block the inflammatory response.
• Before taking any medication, individuals should confirm with their healthcare provider that it is safe.

Cortisone Injections

Successful treatment with a cortisone shot is a sign that surgery will be more effective for individuals who may need surgery.

Cortisone injections can be very helpful in delivering a powerful anti-inflammatory dose directly to the site of inflammation. (Augustine H. Conduah et al., 2010) Cortisone injections should be limited in terms of how many injections are offered to an individual, but in limited doses can be very helpful.

However, cortisone shots should only be performed once the diagnosis is confirmed.

Surgery

• Surgery is seldom necessary but can be effective in individuals who are unable to find relief with conservative treatments.
• Surgery is often used for individuals with abnormal scapular anatomy, like bone growths or tumors.

At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual's ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractor care plans and clinical services are specialized and focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Scapular Winging 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 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

Conduah, A. H., Baker, C. L., 3rd, & Baker, C. L., Jr (2010). Clinical management of scapulothoracic bursitis and the snapping scapula. Sports Health, 2(2), 147–155. https://doi.org/10.1177/1941738109338359

Kuhn, J. E., Plancher, K. D., & Hawkins, R. J. (1998). Symptomatic scapulothoracic crepitus and bursitis. The Journal of the American Academy of Orthopaedic Surgeons, 6(5), 267–273. https://doi.org/10.5435/00124635-199809000-00001

de Souza, A. M., & Bispo Júnior, R. Z. (2014). Osteochondroma: ignore or investigate?. Revista brasileira de ortopedia, 49(6), 555–564. https://doi.org/10.1016/j.rboe.2013.10.002

Can individuals with herniated discs find the relief they are looking for from traction therapy or decompression to provide pain relief?

Introduction

The spine allows the individual to be mobile and flexible without feeling pain and discomfort when a person is on the move. This is because the spine is part of the musculoskeletal system that consists of muscles, tendons, ligaments, the spinal cord, and spinal discs. These components surround the spine and have three regions to allow the upper and lower extremities to do their jobs. However, the spine also ages when the body starts to age naturally. Many movements or routine actions can cause the body to be stiff and, over time, can cause the spinal disc to herniate. When this happens, a herniated disc can lead to pain and discomfort in the extremities, thus making individuals deal with a reduced quality of life and pain in three spinal regions. Luckily, there are numerous treatments, like traction therapy and decompression, to alleviate the pain and discomfort associated with herniated discs. Today’s article looks at why herniated discs cause issues in the spine and the effects of how these two treatments can help reduce herniated discs. We talk with certified medical providers who consolidate our patients’ information to assess how a herniated disc in the spine may be the issue causing musculoskeletal pain. We also inform and guide patients on how integrating spinal decompression and traction therapy can help realign the spine and reduce disc herniation that is causing spinal issues. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments as part of their routine to reduce pain and discomfort in their bodies. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

Why Herniated Discs Causes Issues In The Spine?

Have you been experiencing constant discomfort in your neck or back that doesn’t allow you to relax? Do you feel tingling sensations in your upper and lower extremities, making grasping objects or walking difficult? Or have you noticed that you are hunching over from your desk or standing and that stretching causes pain? As the spine keeps the body upright, its main components include the moveable vertebrae, the nerve root fibers, and spinal discs to help send neuron signals to the brain to allow movement, cushion the shocked forces on the spine, and be flexible. The spine allows the individual to perform various tasks without pain and discomfort through repetitive movements. However, when the body ages, it can lead to degenerative changes in the spine, causing the spinal disc to herniate over time. A herniated disc is a common degenerative musculoskeletal condition that causes the nucleus pulposus to break through any weak region of the annulus fibrosus and compress the surrounding nerve roots. (Ge et al., 2019) Other times, when repetitive motions start to cause a developing herniated disc, the inner portion of the disc can become desiccated and brittle. In contrast, the outer portion becomes more fibrotic and less elastic, causing the disc to shrink and be narrow. A herniated disc can affect young and old populations as they can have a multifactorial contribution that causes proinflammatory changes to the body. (Wu et al., 2020) 

When many people are dealing with pain associated with a herniated disc, the disc itself goes through morphological change through the characterization of the disc being partial damage, which is then followed by the displacement and herniation of the inner disc portion in the vertebral canal to compress the spinal nerve roots. (Diaconu et al., 2021) This causes symptoms of pain, numbness, and weakness in the upper and lower body portions through nerve impingement. Hence why, many individuals are dealing with referred pain symptoms from their arms and legs that are radiating pain. When nerve compression associated with herniated discs starts to cause pain and discomfort, many individuals begin to seek out treatment to reduce the pain that the herniated disc is causing to provide relief for their bodies.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Can individuals dealing with joint pain incorporate acupuncture therapy to manage lupus symptoms and restore body mobility?

Introduction

The immune system is highly important to the body as its main job is to protect vital structures from foreign invaders that can cause pain-like issues and discomfort. The immune system has a healthy relationship with the different body systems, including the musculoskeletal system, as the inflammatory cytokines help heal muscle and tissue damage when the body is injured. Over time, however, when normal environmental and genetic factors start to develop in the body, the immune system will begin to send out these cytokines to healthy, normal cells. To that point, the body starts at risk of developing autoimmune diseases. Now, autoimmune diseases in the body can cause havoc over time when they are not managed, leading to chronic disorders that can cause overlapping symptoms in the musculoskeletal system. One of the most common autoimmune diseases is systemic lupus erythematosus or lupus, and it can cause a person to be in consistent pain and discomfort while correlating with muscle and joint pain. Today’s article looks at the factors and effects of lupus, the burden of joint pain in lupus, and how holistic approaches like acupuncture can help manage lupus while restoring body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how to minimize the pain effects caused by lupus on the joints. We also inform and guide patients on how acupuncture can help manage lupus and combine other therapies to reduce its pain-like symptoms affecting the musculoskeletal system. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating acupuncture therapy to relieve the inflammatory effects of lupus while finding natural ways to restore mobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

The Factors & Effects Of Lupus

Have you been experiencing joint pain in your upper or lower extremities, making it difficult to function throughout the day? Have you been feeling the constant effects of fatigue? Many individuals experiencing these pain-like issues could risk developing systemic lupus erythematosus. In this autoimmune disease, the body’s own immune system mistakenly starts to attack its tissues, thus leading to inflammation and a range of pain-like symptoms. Lupis is tricky to diagnose because of its complex immune dysregulation that can lead to an overproduction of cytokines that can affect the body. (Lazar & Kahlenberg, 2023) At the same time, lupus can affect a diverse population, with symptoms and severity varying depending on how mild or severe the factors affect the body. Lupus can impact various body parts, including the joints, skin, kidneys, blood cells, and other vital body parts and organs, as environmental and hormonal factors can influence its development. (Tsang & Bultink, 2021) Additionally, lupus can be closely associated with other comorbidities that are causing overlapping risk profiles with inflammation that can affect the joints in the musculoskeletal system.

The Burden of Joint Pain In Lupus

Lupus is tricky to diagnose since it often mimics other ailments; the most common pain symptom that lupus affects is the joints. Individuals with lupus experience joint pain, which can cause inflammatory effects and structural damage to the joints, tendons, muscles, and bones, causing pathological abnormalities. (Di Matteo et al., 2021) Since lupus causes inflammatory effects in the joints, many individuals will think that they are experiencing inflammatory arthritis, and it can cause overlapping risk profiles as it is accompanied by lupus, thus causing localized pain in the joints regardless of its origin. (Senthelal et al., 2024) Joint pain in lupus individuals can significantly hinder daily activities, reducing mobility and overall quality of life as they are trying to find relief. 

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Can individuals with osteoarthritis find the relief they deserve through electroacupuncture to restore knee and hip mobility?

Introduction

The lower extremities provide movement and stability to the body, allowing people to be in motion. The hips, lower back, knees, and feet each have a function to do, and when traumatic issues start to affect the spinal structures, it can cause numerous symptoms to pop up and cause pain-like symptoms. Additionally, degenerative factors are natural to the joints of the lower extremities as many people make repetitive motions to their bodies that lead to the degenerative process. One of the most common degenerative issues that affect the lower extremities is osteoarthritis, which can make many people feel miserable. Today’s article looks at how osteoarthritis affects the lower extremities and how treatments like electroacupuncture reduce inflammation associated with osteoarthritis and restore knee and hip mobility. We talk with certified medical providers who consolidate our patients’ information to understand better how osteoarthritis affects their lower extremities. We also inform and guide patients on how electroacupuncture therapy can help reduce the inflammatory effects of osteoarthritis affecting the hips and knees. We encourage our patients to ask their associated medical providers intricate and important questions about reducing the progression of osteoarthritis through non-surgical treatments. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

Osteoarthritis Affecting The Lower Extremities

Have you been dealing with stiffness in your knees, hips, and lower back in the mornings? Do you feel like you are wobbling a bit too much when walking? Or do you think radiating heat and swelling in your knees? When people experience these inflammatory pain issues in their joints, it is due to osteoarthritis, a degenerative joint disorder affecting the cartilage between the bones and the tissue components surrounding the joint. Osteoarthritis is multifactorial, meaning it can be idiopathic or secondary while influenced by heredity factors. (Bliddal, 2020) The most common places where people experience osteoarthritis are the lower back, hand, hips, and, most commonly, the knees. Some of the major environmental factors that contribute to the development of osteoarthritis include:

• Obesity
• Age
• Repetitive motions
• Family history
• Injuries

When people are dealing with osteoarthritis, environmental factors can lead to weight overloading on the joints, which results in compression and inflammation. (Nedunchezhiyan et al., 2022) 

When inflammation is associated with osteoarthritis, it can cause the joints and surrounding muscle tissues to swell and feel hot to the touch. At the same time, osteoarthritis is one of the leading causes of disability that can become a socio-economic issue for many people. (Yao et al., 2023) This is because many individuals with osteoarthritis have comorbidities that are associated with the effects of inflammatory cytokines, which can cause them to be physically inactive and miserable. (Katz et al., 2021) However, there are various ways to reduce the progression of osteoarthritis and reduce the inflammatory effects on the joints. 

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 dealing with plantar fasciitis, every step can be painful. Can taking an integrative approach and utilizing acupuncture help treat this condition and accelerate symptom relief?

Acupuncture Plantar Fasciitis

Plantar fasciitis is when the supportive tissue running under the foot, from the heel to the base of the toes, becomes irritated and painful. The disorder can be difficult to manage, but there are alternative treatment options. Acupuncture plantar fasciitis therapy is one potential method of relief, alleviating pain, and returning the individual to regular activities. Acupuncture involves inserting extremely thin needles into points in the body to restore and balance the normal flow of energy and improve overall health. (Johns Hopkins University. 2024) In traditional Chinese medicine or TCM, the body comprises a series of meridians/channels that supply energy flow or qi/chi.

Facts

Plantar fasciitis is a common disorder affecting the foot. The condition occurs when the plantar fascia, designed to absorb the forces that travel through the arch of the foot, becomes overloaded. When the bottom of the foot is constantly subjected to high amounts of strain, it leads to ligament degeneration, pain, and inflammation. The most common symptom is heel pain, the first thing an individual experiences in the morning or after a long day of work and activities. Anyone can get plantar fasciitis, but those who are more prone to the condition include individuals with:

• Tight calf muscles
• High arches
• Obesity issues
• Who participate in repetitive activities. (American Academy of Orthopaedic Surgeons. 2022)

1. The disorder is first treated conservatively with physical therapy focusing on relieving the pain symptoms and restoring foot and ankle flexibility.
2. Orthotics or custom-fabricated shoe inserts can help protect the foot and correct foot positioning,
3. Night splints help hold the foot in a flexed position at night.
4. Anti-inflammatory medications may also be used. (American Academy of Orthopaedic Surgeons. 2022)

Benefits of Acupuncture

Acupuncture and its effectiveness are still being studied, but there is evidence suggesting that it is beneficial in plantar fasciitis treatment.

• One review found significant pain improvements in individuals who had acupuncture for the condition compared to individuals who received standard treatments like stretching, orthotics, and strengthening. (Anandan Gerard Thiagarajah 2017) The same review also found benefits when comparing acupuncture to a placebo version of the treatment, further reinforcing the findings.
• Another medical review found that acupuncture helped alleviate heel pain and improve daily function when combined with nonsteroidal anti-inflammatory medications/NSAIDs such as ibuprofen or naproxen. (Richard James Clark, Maria Tighe 2012)

Side Effects

While acupuncture plantar fasciitis therapy is beneficial, it is important to remember there can be potential side effects that can include:

• Pain in the area where the needles were placed.
• Bleeding in the area where the needles were placed.
• Bruising or skin discoloration.
• Allergic reaction or contact dermatitis/itchy rash.
• Dizziness or light-headedness.
• Nausea or vomiting (Malcolm W C Chan et al., 2017)

The chances of a serious adverse side effect are relatively low when undergoing acupuncture on the foot.

Acupuncture Points and Sensations

The ways acupuncture works are not yet fully understood, but like other neuromusculoskeletal therapies, the process activates the body's healing properties.

• Inserting a needle into the body’s points stimulates the central nervous system.
• This leads to the release of chemicals in the brain, spinal cord, and muscles that promote healing.
• These same chemicals and reactions also reduce the body’s sensation of pain. (Teng Chen et al., 2020)

Number of Sessions

The amount of sessions that acupuncture takes to provide pain relief varies from person to person and case to case.

• One review found that treating plantar fasciitis weekly with acupuncture produced significant pain relief after four to eight weeks. (Anandan Gerard Thiagarajah 2017)
• This corresponds to another medical review that included a study showing significantly improved pain levels in individuals undergoing weekly acupuncture sessions for four weeks. (Richard James Clark, Maria Tighe 2012)

Individuals are recommended to consult a healthcare provider about personalized treatment plans and if they have a bleeding disorder, are on blood thinner medications, or are pregnant.

Understanding 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 discuss the subject matter above further, 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

Johns Hopkins University. (2024). Acupuncture (Health, Issue. https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

American Academy of Orthopaedic Surgeons. (2022). Plantar fasciitis and bone spurs. (Diseases and Conditions, Issue. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs

Thiagarajah A. G. (2017). How effective is acupuncture for reducing pain due to plantar fasciitis?. Singapore medical journal, 58(2), 92–97. https://doi.org/10.11622/smedj.2016143

Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 30(4), 298–306. https://doi.org/10.1136/acupmed-2012-010183

Chan, M. W. C., Wu, X. Y., Wu, J. C. Y., Wong, S. Y. S., & Chung, V. C. H. (2017). Safety of Acupuncture: Overview of Systematic Reviews. Scientific reports, 7(1), 3369. https://doi.org/10.1038/s41598-017-03272-0

Chen, T., Zhang, W. W., Chu, Y. X., & Wang, Y. Q. (2020). Acupuncture for Pain Management: Molecular Mechanisms of Action. The American journal of Chinese medicine, 48(4), 793–811. https://doi.org/10.1142/S0192415X20500408

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*

 Can understanding the body's hinge joints and how they operate help with mobility and flexibility problems and manage conditions for individuals with difficulty fully bending or extending their fingers, toes, elbows, ankles, or knees?

Hinge Joints

A joint forms where one bone connects to another, allowing motion. Different types of joints differ in structure and movement depending on their location. These include hinge, ball and socket, planar, pivot, saddle, and ellipsoid joints. (Boundless. General Biology, N.D.) Hinge joints are synovial joints that move through one plane of motion: flexion and extension. Hinge joints are found in the fingers, elbows, knees, ankles, and toes and control movement for various functions. Injuries, osteoarthritis, and autoimmune conditions can affect hinge joints. Rest, medication, ice, and physical therapy can help alleviate pain, improve strength and range of motion, and help manage conditions.

Anatomy

A joint is formed by the joining of two or more bones. The human body has three main classifications of joints, categorized by the degree to which they can move. These include: (Boundless. General Biology, N.D.)

Synarthroses

• These are fixed, immovable joints.
• Formed by two or more bones.

Amphiarthroses

• Also known as cartilaginous joints.
• A fibrocartilage disc separates the bones that form the joints.
• These movable joints allow for a slight degree of movement.

Diarthroses

• Also known as synovial joints.
• These are the most common freely mobile joints that allow movement in multiple directions.
• The bones that form the joints are lined with articular cartilage and enclosed in a joint capsule filled with synovial fluid that allows for smooth motion.

Synovial joints are classified into different types depending on differences in structure and the number of motion planes they allow. A hinge joint is a synovial joint that allows movement in one plane of motion, similar to a door hinge that moves forward and backward. Within the joint, the end of one bone is typically convex/pointed outward, with the other concave/rounded inward to allow the ends to fit smoothly. Because hinge joints only move through one plane of movement, they tend to be more stable than other synovial joints. (Boundless. General Biology, N.D.) Hinge joints include:

• The finger and toe joints - allow the fingers and toes to bend and extend.
• The elbow joint - allows the elbow to bend and extend.
• The knee joint - allows the knee to bend and extend.
• The talocrural joint of the ankle - allows the ankle to move up/dorsiflexion and down/plantarflexion.

Hinge joints allow the limbs, fingers, and toes to extend away and bend toward the body. This movement is essential for activities of daily living, such as showering, getting dressed, eating, walking, standing up, and sitting down.

Conditions

Osteoarthritis and inflammatory forms of arthritis can affect any joint (Arthritis Foundation. N.D.) Autoimmune inflammatory forms of arthritis, including rheumatoid and psoriatic arthritis, can cause the body to attack its joints. These commonly affect the knees and fingers, resulting in swelling, stiffness, and pain. (Kamata, M., Tada, Y. 2020) Gout is an inflammatory form of arthritis that develops from elevated levels of uric acid in the blood and most commonly affects the hinge joint of the big toe. Other conditions that affect hinge joints include:

• Injuries to the cartilage within the joints or ligaments that stabilize the outside of the joints.
• Ligament sprains or tears can result from jammed fingers or toes, rolled ankles, twisting injuries, and direct impact on the knee.
• These injuries can also affect the meniscus, the tough cartilage within the knee joint that helps cushion and absorb shock.

Rehabilitation

Conditions that affect hinge joints often cause inflammation and swelling, resulting in pain and limited mobility. After an injury or during an inflammatory condition flare-up, limiting active movement and resting the affected joint can reduce increased stress and pain.

• Applying ice can decrease inflammation and swelling.
• Pain-relieving medications like NSAIDs can also help reduce pain. (Arthritis Foundation. N.D.)
• Once the pain and swelling start to subside, physical and/or occupational therapy can help rehabilitate the affected areas.
• A therapist will provide stretches and exercises to help improve the joint range of motion and strengthen the supporting muscles.
• For individuals experiencing hinge joint pain from an autoimmune condition, biologic medications to decrease the body’s autoimmune activity are administered through infusions delivered every several weeks or months. (Kamata, M., Tada, Y. 2020)
• Cortisone injections may also be used to decrease inflammation.

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes and improving ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use an integrated approach to create personalized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. Our goal is to relieve pain naturally by restoring health and function to the body. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments.

Chiropractic Solutions

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Boundless. General Biology. (N.D.). 38.12: Joints and Skeletal Movement - Types of Synovial Joints. In. LibreTexts Biology. https://bio.libretexts.org/Bookshelves/Introductory_and_General_Biology/Book%3A_General_Biology_%28Boundless%29/38%3A_The_Musculoskeletal_System/38.12%3A_Joints_and_Skeletal_Movement_-_Types_of_Synovial_Joints

Arthritis Foundation. (N.D.). Osteoarthritis. Arthritis Foundation. https://www.arthritis.org/diseases/osteoarthritis

Kamata, M., & Tada, Y. (2020). Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review. International journal of molecular sciences, 21(5), 1690. https://doi.org/10.3390/ijms21051690

Can individuals with joint hypermobility find relief through nonsurgical treatments in reducing pain and restoring body mobility?

Introduction

When a person moves their body, the surrounding muscles, joints, and ligaments are incorporated into various tasks that allow them to stretch and be flexible without pain or discomfort. Many repetitive motions enable the individual to continue their routine. However, when the joints, muscles, and ligaments are stretched farther than normal in the upper and lower extremities without pain, it is known as joint hypermobility. This connective tissue disorder can correlate with other symptoms that affect the body and cause many people to seek treatment to manage joint hypermobility symptoms. In today’s article, we will look at joint hypermobility and how various non-surgical treatments can help reduce pain caused by joint hypermobility and restore body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how their pain may be associated with joint hypermobility. We also inform and guide patients on how integrating various non-surgical treatments can help improve joint function while managing the associated symptoms. We encourage our patients to ask their associated medical providers intricate and insightful questions about incorporating non-surgical therapies as part of their routine to reduce pain and discomfort from joint hypermobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

What Is Joint Hypermobility?

Do you often feel your joints locked up in your hands, wrists, knees, and elbows? Do you experience pain and fatigue in your joints when your body feels constantly tired? Or when you stretch your extremities, do they extend farther than usual to feel the relief? Many of these various scenarios are often correlated with individuals experiencing joint hypermobility. Joint hypermobility is an inherited disorder with autosomal dominant patterns that characterize joint hyperlaxity and musculoskeletal pain within the body extremities. (Carbonell-Bobadilla et al., 2020) This connective tissue condition is often related to the flexibility of the connected tissues like ligaments and tendons in the body. An example would be if a person’s thumb is touching their inner forearm without feeling pain or discomfort, they have joint hypermobility. Additionally, many individuals dealing with joint hypermobility will often have a difficult diagnosis as they will develop skin and tissue fragility over time, causing musculoskeletal complications. (Tofts et al., 2023)

When individuals deal with joint hypermobility over time, many often have symptomatic joint hypermobility. They will present with musculoskeletal and systemic symptoms that lead to displaying skeletal deformities, tissue and skin fragility, and structural differences in the body’s system. (Nicholson et al., 2022) Some of the symptoms that joint hypermobility are shown in a diagnosis include:

• Muscle pain and joint stiffness
• Clicking joints
• Fatigue
• Digestive issues
• Balance issues

Luckily, there are various treatments that many people can use to help restrengthen the surrounding muscles around the joints and reduce the correlating symptoms caused by joint hypermobility. 

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 sacroiliac joint/SIJ dysfunction and pain, could applying kinesiology tape help bring relief and manage symptoms?

Kinesiology Tape For Sacroiliac Joint Pain

A lower back ailment that is common during pregnancy. The pain is usually on one or both sides of the back, just above the buttocks, that comes and goes and can limit the ability to bend, sit, and perform various physical activities. (Moayad Al-Subahi et al., 2017) The therapeutic tape provides support while allowing for movement and may help treat and manage sacroiliac joint/SIJ pain by:

• Decreasing muscle spasms.
• Facilitating muscular function.
• Increasing blood circulation to and around the pain site.
• Decreasing muscle trigger points.

Mechanism

Some studies have found that taping the SI joint has benefits that include:

• Improved joint function
• Increased lumbar flexibility
• Reduced pain and disability. (Do-Yun Shin and Ju-Young Heo. 2017)

1. One theory is it helps lift and hold the overlying tissues off of the SI joint, which helps decrease the pressure around it.
2. Another theory is that lifting the tissues helps create a pressure differential under the tape, like non-surgical decompression, allowing increased circulation to the tissues surrounding the sacroiliac joint.
3. This floods the area with blood and nutrients, creating an optimal healing environment.

Application

A sacroiliac joint on the right and left sides connects the pelvis to the sacrum or the lowest part of the spine. To apply the kinesiology tape correctly, locate the lowest part of the back within the pelvic area. (Francisco Selva et al., 2019) Ask a friend or family member for help if you can't reach the area.

Taping steps:

• Cut three strips of tape, each 4 to 6 inches long.
• Sit in a chair and bend the body slightly forward.
• If someone is helping, you can stand and slightly bend forward.
• Remove the lift-off strip in the middle and stretch the tape to expose several inches, leaving the ends covered.
• Apply the exposed tape at an angle over the SI joint, like making the first line of an X, just above the buttocks, with full stretch on the tape.
• Peel the lift-off strips from the ends and adhere them with no stretching.
• Repeat the application steps with a second strip, adhering at a 45-degree angle to the first strip, making the X over the sacroiliac joint.
• Repeat this with the final strip horizontally across the X made from the first two pieces.
• There should be a tape pattern of star shape over the sacroiliac joint.

1. Kinesiology tape can stay over the sacroiliac joint for three to five days.
2. Watch for signs of irritation around the tape.
3. Remove the tape if the skin becomes irritated, and consult your primary healthcare provider, physical therapist, or chiropractor for other treatment options.
4. Some individuals with specific conditions should avoid using the tape and get confirmation that it's safe.
5. Individuals with severe sacroiliac pain where self-management is not working should see a healthcare provider, physical therapist, and or chiropractor for an evaluation and to learn therapeutic exercises and treatments to help manage the condition.

Sciatica During Pregnancy

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Al-Subahi, M., Alayat, M., Alshehri, M. A., Helal, O., Alhasan, H., Alalawi, A., Takrouni, A., & Alfaqeh, A. (2017). The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. Journal of physical therapy science, 29(9), 1689–1694. https://doi.org/10.1589/jpts.29.1689

Do-Yun Shin and Ju-Young Heo. (2017). The Effects of Kinesiotaping Applied onto Erector Spinae and Sacroiliac Joint on Lumbar Flexibility. The Journal of Korean Physical Therapy, 307-315. https://doi.org/https://doi.org/10.18857/jkpt.2017.29.6.307

Selva, F., Pardo, A., Aguado, X., Montava, I., Gil-Santos, L., & Barrios, C. (2019). A study of reproducibility of kinesiology tape applications: review, reliability and validity. BMC musculoskeletal disorders, 20(1), 153. https://doi.org/10.1186/s12891-019-2533-0

Can plantar fasciitis patients incorporate non-surgical treatments to reduce hip pain and restore mobility?

Introduction

Everyone is on their feet constantly as it helps people stay mobile and allows them to go from one location to another. Many people are constantly on their feet from childhood to adulthood. This is because the feet are part of the lower musculoskeletal extremities that stabilize the hips and allow sensory-motor function to the legs, thighs, and calves. The feet also have various muscles, tendons, and ligaments surrounding the skeletal structure to prevent pain and discomfort. However, when repetitive motions or injuries start to affect the feet, it can lead to plantar fasciitis and, over time, cause overlapping risk profiles that lead to hip pain. When people are experiencing these pain-like conditions, it can significantly affect their daily activities and overall quality of life. When this happens, many people seek various treatments to reduce the pain-like symptoms caused by plantar fasciitis and restore hip mobility. Today’s article looks at how plantar fasciitis correlates with hip pain, the connection between the feet and the hips, and how there are non-surgical solutions to reduce plantar fasciitis. We talk with certified medical providers who consolidate our patients’ information to assess how to mitigate plantar fasciitis and restore hip mobility. We also inform and guide patients on how numerous non-surgical treatments can help strengthen weak muscles associated with plantar fasciitis and help with restoring stabilization from hip pain. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating small changes to reduce the pain-like effects caused by plantar fasciitis. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

How Plantar Fasciitis Correlates With Hip Pain

Do you experience pain in your heels constantly after a long walk? Do you feel stiffness in your hips when stretching? Or do you feel your shoes are causing tension and pain in your feet and calves? Often, many of these pain-like scenarios are due to people dealing with plantar fasciitis, characterized by heel pain due to inflammation or degenerative irritation of the plantar fascia, a band of thick tissues is running across the bottom of the foot and connecting to the heel bone to the toes in the lower extremities. This band of tissues plays an essential role in the body, providing normal biomechanics to the foot while supporting the arch and helping with shock absorption. (Buchanan et al., 2024) Plantar fasciitis can affect the stability of the lower extremities since the pain affects the feet and causes hip pain.

So, how would plantar fasciitis correlate with hip pain? With plantar fasciitis, many people are experiencing pain in their feet. It can lead to abnormal foot posture, lower extremity muscle weakness, and muscle stress that can reduce the stability of the legs and hip muscles. (Lee et al., 2022) With hip pain, many people can experience a gait dysfunction that causes muscle weakness in the lower extremities and causes the accessory muscles to perform the primary muscles’ jobs. To that point, this forces people to scrap the ground when walking. (Ahuja et al., 2020) This is because normal conditions like natural aging, muscle overuse, or trauma can cause pain-like symptoms to the hips, including discomfort on the thighs, groin, and buttock region, joint stiffness, and reduced range of motion. Hip pain can cause overlapping risk profiles that may include repetitive strain on the feet, thus leading to symptoms of sharp to dull aches on the heel.

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 with arthritis, can incorporating acupuncture with other therapies help manage pain and other symptoms?

Acupuncture For Arthritis

Acupuncture has been around for thousands of years and is a form of traditional Chinese medicine that utilizes needles inserted into various parts of the body to relieve pain and inflammation. The practice is based on the concept of life energy that flows throughout the body along pathways called meridians. When the energy flow becomes disrupted, blocked, or injured, pain or illness can present. (Arthritis Foundation. N.D.) Further research is needed to determine how the acupuncture therapeutic mechanisms work and the overall effectiveness. However, there is emerging evidence suggesting that acupuncture can provide symptom relief for individuals with joint pain, especially those with osteoarthritis and rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Benefits

The actual method that reduces the pain and inflammation is still unclear. Theories include that the needles suppress inflammatory responses, improve blood flow, and relax muscles. Although acupuncture cannot cure or reverse arthritis, it may be useful for managing pain and decreasing associated symptoms, especially in combination with other therapies. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Rheumatoid Arthritis

A systematic review of 43 studies, including humans and animals with rheumatoid arthritis, demonstrated varied results. Several studies showed improvement in symptoms and decreased biological markers of rheumatoid arthritis following one to three sessions of acupuncture for four weeks or more. (Sharon L. Kolasinski et al., 2020) Beneficial outcomes following acupuncture treatment for rheumatoid arthritis include:

• Reduced pain
• Reduced joint stiffness
• Improved physical function

The results of the human and animal studies suggested that acupuncture has the potential to down-regulate:

• Levels of interleukins
• Levels of tumor necrosis factor
• Specific cell signaling proteins/cytokines involved in the inflammatory response, which become elevated in autoimmune conditions like rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)
• Most of the study subjects were also receiving other forms of treatment, especially medication. Therefore, it is difficult to conclude how beneficial acupuncture is alone or as a supplemental addition to other medical treatments. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Osteoarthritis

Acupuncture for osteoarthritis of the hand, hip, and knee is recommended, according to the American College of Rheumatology and Arthritis Foundation, meaning that it may be worth trying, although more research is needed to confirm its effectiveness. However, since the risk is relatively minor, acupuncture is generally considered a safe alternative treatment option for managing the symptoms. (Sharon L. Kolasinski et al., 2020)

Chronic Pain

As clinical trials suggest that acupuncture may be effective in providing pain relief, it may be a recommended option for individuals suffering from chronic pain. A recent systematic review of 20,827 patients and 39 trials concluded that acupuncture is effective for the treatment of chronic musculoskeletal pain, headache, and osteoarthritis pain. (Andrew J. Vickers et al., 2018)

Other possible benefits include the antioxidative effects: (Pei-Chi Chou, Heng-Yi Chu. 2018)

• Alleviating oxidative stress and inflammation
• Improving energy metabolism
• Triggering the release of endorphins/hormones that help reduce pain.

Safety

• Acupuncture is considered a safe procedure by a licensed and certified professional.
• To practice acupuncture in the United States, an acupuncturist needs a minimum of a master’s degree from a program accredited by the American Academy of Acupuncture and Oriental Medicine and a license in the state where they received their acupuncture treatment.
• Doctors with an MD or DO degree licensed in the United States to practice medicine can also be licensed by the American Academy of Medical Acupuncture after additional training.

Risks

Risks associated with acupuncture are bleeding and bruising, especially for individuals who have a bleeding disorder like hemophilia or take a blood thinning medication. Individuals are recommended to talk to their healthcare provider to determine if acupuncture is a safe option.

Side Effects

Most individuals do not experience any side effects, although possible reactions can include: (Shifen Xu et al., 2013)

• Soreness
• Bruising
• Scarring
• Needle shock: a vasovagal response that presents as feeling faint, clammy hands, chills, and slight nausea.

Acupuncture Session

• During the initial treatment, individuals will discuss their medical history and what joints and areas of their bodies are presenting with symptoms.
• After a physical exam, the individual will lie on a treatment table.
• Individuals may be face up or down depending on what areas of the body the acupuncturist needs to access.
• It is recommended to wear loose clothing that can be rolled up or moved out of the way to access different areas easily.
• Depending on what areas need to be accessed, individuals may be asked to change into a medical gown.
• The acupuncturist will use alcohol swabs to disinfect the area before inserting the needles.
• The needles are made of stainless steel and are extremely thin.
• Individuals may feel a slight pinch in sensitive areas like the hands and feet, but needle insertion should be comfortable and well-tolerated without significant discomfort.
• For electroacupuncture, the acupuncturist will pass a mild electric current through the needles, typically 40 to 80 volts.
• The needles stay in place for 20 to 30 minutes.
• After the treatment is finished, the acupuncturist will remove the needles and dispose of them.

Frequency

• The frequency of acupuncture sessions will vary depending on the severity of the symptoms and whether the visits are approved and reimbursed by the health insurance company.

Cost and Insurance

• Costs for acupuncture can vary from $75 to $200 per session.
• The first session, which involves an initial assessment and evaluation, usually costs more than follow-up visits.
• Whether the health insurance will cover some or all of the costs of acupuncture sessions depends on the individual insurance company and the condition being treated.
• Medicare currently covers acupuncture services up to 12 visits within a 90-day period for chronic low back pain only.
• Medicare will not cover acupuncture for other conditions. (Medicare.gov. N.D.)

Acupuncture is not a cure for arthritis, but it may be a useful tool to help manage pain and other symptoms. Make sure to consult a healthcare provider if acupuncture is safe to try based on medical history.

Arthritis Explained

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 discuss the subject matter above further, 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

Arthritis Foundation. (N.D.). Acupuncture for arthritis (Health & Wellness, Issue. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/acupuncture-for-arthritis

Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 8596918. https://doi.org/10.1155/2018/8596918

Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis care & research, 72(2), 149–162. https://doi.org/10.1002/acr.24131

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists' Collaboration (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005

Xu, S., Wang, L., Cooper, E., Zhang, M., Manheimer, E., Berman, B., Shen, X., & Lao, L. (2013). Adverse events of acupuncture: a systematic review of case reports. Evidence-based complementary and alternative medicine : eCAM, 2013, 581203. https://doi.org/10.1155/2013/581203

Medicare.gov. (N.D.). Acupuncture. Retrieved from https://www.medicare.gov/coverage/acupuncture

Progress can be challenging for individuals in post total ankle replacement surgery. How can physical therapy help in recovery and restoring leg function?

Total Ankle Replacement Post Surgery Physical Therapy

Total ankle replacement surgery is a major procedure that takes time to recover. A total ankle replacement surgery or arthroplasty can benefit individuals with chronic ankle pain or disability. This procedure can significantly improve an individual's overall pain and function with time. Physical therapy is essential to regaining movement in the ankle and restoring full mobility. A physical therapist will work with the individual to control pain and swelling, restore the ankle's range of motion, train on walking gait and balance, and rebuild strength in the leg. This will help maximize the chances of a successful outcome after surgery.

Total Ankle Replacement

The ankle joint is the section of the lower leg where the shinbone/tibia meets the talus bone on the top of the foot. What can happen is the slippery surface/articular cartilage that coats the ends of these bones begins to thin or deteriorate. As the deterioration progresses, it can lead to significant pain, disability, and difficulty walking. (Cleveland Clinic. 2021) This is where a specialist may recommend total ankle replacement for the best results. Various conditions can be helped by this procedure, including:

• Joint damage caused by gout
• Post-traumatic arthritis
• Rheumatoid arthritis
• Advanced osteoarthritis
• Osteonecrosis
• Septic arthritis (Cort D. Lawton et al., 2017)

During an ankle replacement procedure, an orthopedic surgeon removes the damaged ends of the tibia and talus bones and replaces them with an artificial covering. A polyethylene component is also secured between the two structures to support the smooth movement of the new joint endings. (Massachusetts General Hospital. N.D.) Following the procedure, individuals are typically placed in a protective boot or splint. The healthcare provider will recommend staying off the leg for 4 to 8 weeks to allow healing.

Physical Therapy

Outpatient physical therapy is usually initiated several weeks after the ankle operation. (UW Health Orthopedics and Rehabilitation. 2018) Physical therapy can last for five months or more, depending on the severity of the condition and injury. The physical therapist will focus on different areas to get the best results. (Cort D. Lawton et al., 2017)

Pain and Swelling Control

Post-operative pain and swelling are normal after a total ankle replacement. It is not unusual for an ankle to be swollen for even six to 12 months after the operation. (UW Health Orthopedics and Rehabilitation. 2018) The surgeon will normally prescribe medication to help manage discomfort early on, and physical therapy also plays an important role in addressing the symptoms. Treatments used can include:

• Electrical stimulation - mild electrical pulses applied to the muscles.
• Ice
• Vasopneumatic compression, where an inflatable sleeve is used to create pressure around the area, is commonly utilized at the beginning of physical therapy to reduce pain or swelling.
• Other modalities, such as stretching and targeted exercises, are combined with other treatments.

Range of Motion

• Early after the procedure, the ankle will be very stiff and tight. This is due to several factors, including the inflammation and swelling after surgery and the time spent immobilized in a boot.
• The physical therapist will employ various techniques to improve the ankle joint's range of motion to rotate and flex.
• The physical therapist may employ passive stretching induced by an outside force such as the therapist or a resistance band) to help improve mobility.
• Manual techniques like soft tissue massage and joint mobilizations are also utilized. (Massachusetts General Hospital. N.D.)
• The therapist will develop a home rehabilitation program comprising self-stretching techniques and gentle movements.

Gait and Balance Training 

• After weeks of staying off the affected ankle, the surgeon will clear the patient to begin walking training.
• The physical therapist will work to improve the overall gait pattern and reduce limping.
• They will also help transition from using crutches or a walker to walking independently. (UW Health Orthopedics and Rehabilitation. 2018)
• After multiple weeks of reduced movement and lack of bearing any weight on the ankle, the muscles that surround the ankle have often atrophied/weakened, which can impact balance.
• When the individual can begin placing weight on the leg, the therapist will apply proprioceptive/sense of body position training to improve overall stability. (UW Health Orthopedics and Rehabilitation. 2018)
• Balance exercises will be added to the home program and will progress from week to week.

Strength

The muscles in the leg, ankle, and foot become weak from the surgery and the time spent in a splint or boot. These structures have a significant role in balance, the ability to stand, walk, and go up or down the stairs.

• Regaining the strength and power of these muscles is a critical goal of rehabilitation.
• In the first weeks, the physical therapist will focus on gentle strengthening exercises.
• Isometrics lightly activate the muscles but avoid irritating the surgical site.
• As time passes and weight-bearing is allowed, these gentle moves are replaced with more challenging ones, like resistance bands and standing exercises, to accelerate strength gains.

Treating Ankle Sprains with Chiropractic Care

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 discuss the subject matter above further, 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

Cleveland Clinic. (2021). Total ankle replacement.

Lawton, C. D., Butler, B. A., Dekker, R. G., 2nd, Prescott, A., & Kadakia, A. R. (2017). Total ankle arthroplasty versus ankle arthrodesis-a comparison of outcomes over the last decade. Journal of orthopaedic surgery and research, 12(1), 76. https://doi.org/10.1186/s13018-017-0576-1

Massachusetts General Hospital. (N.D.). Physical therapy guidelines for total ankle arthroplasty.

UW Health Orthopedics and Rehabilitation. (2018). Rehabilitation guidelines following total ankle arthroplasty.

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