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Flexibility is the ability of joint/s to move through an unrestricted range of motion. To maintain joint health, the cartilage and structures within the joint need a constant supply of blood, nutrients, and synovial fluid to move through a full range of motion. The range of motion is influenced by the mobility of the soft tissues that surround the joint. These soft tissues include muscles, ligaments, tendons, joint capsules, and skin. Factors affecting the loss of normal joint flexibility include injury, inactivity, or little to no stretching. Although flexibility varies for everybody, minimum ranges are necessary for maintaining total body health. Injury Medical Chiropractic and Functional Medicine Clinic can create a personalized stretching program to restore joint flexibility. Joint Flexibility Body Effects - Not stretching the body can lead to fatigue, weakness, and soft tissue shortening.
- The effect can be particularly noticeable in weight-bearing joints like the hips and knees.
- If the joints become weak, the risk of injury increases.
- Inflexible muscles tire more quickly, causing opposing muscle groups to work harder.
- Muscle fatigue can lead to muscular injuries and the inability to protect the joints from more severe injuries.
- Decreased flexibility can also lead to added stress on structures and tissues in a different body area from the source of the inflexibility.
- An example is tendonitis in the knee can be related to calf tightness.
Stretching Routine Benefits Research has shown that stretching can help improve flexibility and, as a result, the range of motion of the joints. Benefits include: - Improved performance in physical activities.
- Improved ability with daily activities.
- Decreased risk of injuries.
- Increase circulation.
- Improved muscle function.
Testing Flexibility can be measured with functional tests. These tests measure the joint's range within common movement patterns. Using these tests, areas of inflexibility can be identified and addressed. The tests look at the following: - Neuromuscular coordination.
- How the muscles return to a normal resting state.
- Blood circulation and recirculation.
- Typical assessment areas include the lower back, hips, hamstrings, knees, and feet.
Stretching the Body Developing a regular stretching routine to be incorporated into a training program is recommended. A stretching routine should cover all the major muscle groups of the body as well as any specific muscle groups. Implementing a physical therapy stretching program can help individuals stay motivated, as gaining flexibility takes time. It can take several weeks of consistent, regular stretching for improvement. - Stretching with a physical therapist will target the largest areas of inflexibility.
- Stretching sessions can be 20 minutes or more.
- Once these areas have been addressed, the therapist will move on to more specific areas.
- The therapist will train the individual how to stretch at home.
The therapist will provide specific guidelines that should be followed for stretching at home: - Stretching when muscles are cold could lead to a strain or pull.
- Warming up before stretching is recommended as it increases the blood flow and temperature of the muscles, ligaments, and tendons, improving the elasticity and functioning of the tissues.
- Begin each stretch slowly and gently.
- Maintain the stretch position for 30 seconds, and gradually increase to 1-2 minutes.
- Maintain a regular breathing pattern when stretching.
- Stay relaxed, and do not bounce.
- There should be pulling or tightness but not pain.
- Static stretching should gradually go through the full range of motion until the resistance is felt.
- Stretch to the point of tightness and then just beyond.
- Gradually release the stretch.
- Repeat daily.
A stretching therapy program keeps the body loose and effectively increases the mobility of all soft tissues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Behm DG. Does stretching affect performance? In: The Science and Physiology of Flexibility and Stretching. Kindle edition. Routledge; 2019. Berg, K. Stretching fundamentals. In: Prescriptive Stretching. 2nd ed. Kindle edition. Human Kinetics; 2020. Ghasemi, Cobra, et al. "The effect of soft tissue manipulation and rest on knee extensor muscles fatigue: Do torque parameters and induced perception following muscle fatigue have enough reliability?." Journal of family medicine and primary care vol. 9,2 950-956. 28 Feb. 2020, doi:10.4103/jfmpc.jfmpc_838_19 Gordon BT, et al., eds. Flexibility assessments and exercise programming for apparently healthy participants. In: ACSM's Resources for the Exercise Physiologist. 3rd ed. Kindle Edition. Wolters Kluwer; 2022. Hui, Alexander Y et al. "A systems biology approach to synovial joint lubrication in health, injury, and disease." Wiley interdisciplinary reviews. Systems biology and medicine vol. 4,1 (2012): 15-37. doi:10.1002/wsbm.157 Lindstedt, Stan L. "Skeletal muscle tissue in movement and health: positives and negatives." The Journal of experimental biology vol. 219, Pt 2 (2016): 183-8. doi:10.1242/jeb.124297
Back discomfort and pain could be caused by hip issues and could be resolved with hip replacement. According to a recent study, a total hip replacement solved back pain in four out of five individuals dealing with spinal discomfort and pain. When the hip/s are stiff or cannot move normally, this places added pressure on the spine. Studies show that low back pain was resolved in 82% of individuals after a total hip replacement known as total hip arthroplasty or THA. The body is designed as a fluid chain with fluid motion connecting the neck all the way down to the toes. When a region like the hip tightens/stiffens, it generates added stress/pressure on the other areas of the body, which in this case happens to be the lower spine. Individuals with mild arthritis of the spine are able to experience increased pain reduction than individuals with severe arthritis. An insight into the relationship between the hips and low back that can lead to accurate diagnoses and optimal treatment plans. Hip Issues The hip/s move with the lower back during activities like walking, sitting, bending, etc. Tight muscles, normal wear-and-tear, and osteoarthritis can reduce hip movement, forcing the lower back to make awkward and poor posture causing adjustments. Individuals usually relieve the painful position by increasing the curve of their lower back. If an individual has severe arthritis of the hip, they put a lot of stress and pressure on the low back that often results in low back pain. Advanced hip osteoarthritis is the breakdown of joint cartilage and the most common type of arthritis. Individuals with this type experience low back pain 50% of the time, and even higher depending on the individual's condition. 80% to 90% of individuals with hip or knee arthritis, unfortunately, develop low back arthritis. There is not yet a clear reason as to why this occurs. It is theorized that some osteoarthritis risk factors like obesity and high-impact/force activities can be modified with lifestyle adjustments. Other risk factors that include injury, trauma, age, and congenital conditions like hip dysplasia, cannot be avoided. Hip osteoarthritis isn’t the only hip issue that can also cause lower back pain. Other hip issues. Sacroiliac joint dysfunction The sacroiliac joint connects the sacrum to the pelvis. It is a shock absorber between the upper body, the pelvis and can stiffen with time. Sacroiliac joint pain affects around 15% to 25% of individuals with low back pain. It worsens when climbing stairs, getting up from a seated position or running. Symptoms include: - Low back pain
- Pain in buttock/s
- Groin pain
- Stiffness
- Instability
Piriformis syndrome About 200,000 individuals each year are affected with piriformis syndrome and is often misdiagnosed as symptoms resemble sciatica. What happens is the piriformis muscle, which connects the sacrum to the top of the femur, tightens/irritates the sciatic nerve. Symptoms are often mistaken for sciatica with pain in the buttocks, numbness, and tingling that travels down the back of the leg and into the feet. Diagnosis A doctor or chiropractor will use a combination of diagnostic tools. This typically includes a physical exam, X-rays with other specific tests to help identify the source of pain. What typically happens is a patient will undergo a hip and lumbar spine X-ray, but the thoracic spine, pelvis, and hip areas are missed. Getting the middle segment is critical to see how the spine and hips are working together. It is critical to understand the hip-spine connection. All spine patients should have X-rays of the hips to make sure any problems don't go undetected. The overlap of symptoms with these two areas could be overlooked. If necessary a diagnostic injection into the hip joint can help precisely locate the pain source. This can be done at the clinic or doctor's office using ultrasound or X-ray to guide the needle. If no pain relief results from the injection, hip replacement is still not considered because the pain could be coming from the spine. A critical part of the diagnosis is not just imaging. One of the most important parts is getting a thorough history of symptoms. X-rays and MRI show what the problem could be, however, the symptoms could coming from another area. Treatment Options Before total hip replacement is considered there are nonsurgical approaches to be considered. All diagnoses should start with conservative treatment. Physical therapy, chiropractic, gait training, and core strengthening can optimize the spine to better manage hip issues and arthritis. Conservative therapies could also include: - Weight loss
- Activity modification like walking instead of running
- Anti-inflammatory medication
- Cortisone injections
Total hip replacement is the last option for individuals experiencing pain, difficulty walking, and limited mobility. The procedure removes the damaged cartilage and bone from the hip joint. This includes the head of the thighbone along with the socket where it fits and replaces it with artificial parts. Conclusion Get a second opinion. Individuals are encouraged to educate themselves as much as possible on the condition. The hip and spine is a complex relationship. The most important information for patients is that they understand along with their doctor where the pain is coming from, the hip, spine, or both. Dr. Alex Jimenez’s Blog Post Disclaimer The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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. The provider(s) Licensed in Texas& New Mexico*
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Musculoskeletal pain and pain conditions are common at a chiropractic clinic. Sometimes it is not an apparent injury or illness but an underlying cause originating from an internal organ referring pain to the related somatic/bodily structures. This is known as a viscerosomatic reflex or disturbance. This reflex is a localized visceral stimulus that produces a response in segmentally related somatic structures. It affects the musculoskeletal system's bones, muscles, joints, ligaments, and tendons resulting from a visceral pathologic state or disease. A viscerosomatic reaction happens when a pain signal from an organ gets passed on through the spinal cord, where neurons and peripheral motor structures like the muscles, blood vessels, and skin are interconnected/linked. The life-saving techniques that include the Heimlich maneuver and CPR chest compressions are examples of how one part of the body/organ can get affected/injured/ill and is remedied by treating another part of the body. Viscerosomatic Symptoms Common signs and symptoms include: - Hard to pinpoint general pain
- Skin changes include:
- Sweaty, dry, red, or pale/whitening
- Hypersensitive or chronic discomfort
- Paresthesia
- Rigid muscles and spasms.
- Deep, dull, aching pain that is difficult to reproduce.
- Pain with no pattern could be better or worse in the morning or night, better or worse after activity or resting.
- Chronic pain that lasts 90 days with little to no change.
- Medical history of gastrointestinal, liver, and lung disorders or infections.
Pathology is the study of the causes and effects of disease or injury. A disease or injury in an organ or organ system creates a response in the somatic system. Visceral reflexes produce non-skeletal muscular responses in internal organs like the heart, blood vessels, and organs. Reflexes Somatic and visceral reflexes are two types of neural circuits generated by systems within the peripheral nervous system. These are the somatic nervous system which produces bodily reflexes, and the autonomic nervous system, which creates visceral reflexes. Both are essential for coordinating the central nervous system and the affected organ/s. The difference between somatic and visceral reflexes is that somatic take place in skeletal muscles, and visceral occur in soft tissue organs. Body Organ Links Medical practitioners have accepted particular body organ associations/links, for example: - The left shoulder can serve as an indicator of heat-related distress.
- Below the inferior scapular angle, pain presenting could indicate pancreatic dysfunction and relates to vertebral and rib dysfunction between the thoracic vertebra T5–T9.
- The pancreas usually refers to the left shoulder, as the ligaments interconnect to the stomach, spleen, and left hemidiaphragm muscle and suspend the descending colon.
- Left-sided organs, including the aorta, could be related to the left upper extremity dysfunction or the left-sided myofascial structures between the shoulder blades.
Another example is the right shoulder and upper back pain can indicate liver and gall bladder distress and disease. What Viscerosomatic Reflexes Tell A Chiropractor/Therapist Chronic somatic problems can originate from within the body unless an obvious result of a traumatic incident. It is essential to pay attention to viscerosomatic reflexes because if left untreated, it could lead to chronic problems with multiple issues. - Chiropractic medicine specializes in the musculoskeletal system, combined with a healthy mind-body approach that generates differential diagnosis, including somatic dysfunction/s.
- Benefits include fewer imaging scans.
- Decreased use of prescription pain medications.
- Decreased time in physical therapy.
- Decrease in medical costs.
Chiropractic can bring natural pain relief through their understanding and developed medical skill sets that include the capacity to mobilize the viscera and joint structures, to restore body stability and health. This expanded understanding, combined with the chiropractic physician's knowledge of neuroendocrine reflex systems, can help develop a personalized plan to achieve better health. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Akinrodoye MA, Lui F. Neuroanatomy, Somatic Nervous System. [Updated 2021 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556027/ Bath M, Owens J. Physiology, Viscerosomatic Reflexes. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559218/ Christianson, Julie A., and Brian M. Davis. "The Role of Visceral Afferents in Disease." Translational Pain Research: From Mouse to Man, edited by Lawrence Kruger et al., CRC Press/Taylor & Francis, 2010. Foreman, R D. "Integration of viscerosomatic sensory input at the spinal level." Progress in brain research vol. 122 (2000): 209-21. doi:10.1016/s0079-6123(08)62140-8 Sikandar, Shafaq, and Anthony H Dickenson. "Visceral pain: the ins and outs, the ups and downs." Current opinion in supportive and palliative care vol. 6,1 (2012): 17-26. doi:10.1097/SPC.0b013e32834f6ec9
A doctor could recommend alternative treatments, as part of a plan for neck pain like acupuncture, herbal compounds, and yoga. You may want to try them out yourself. Many have reported that these have really helped. Please consult a doctor before trying any alternative therapies. These are safe but should be set-up by a professional to make sure they are done safely. For example, there could be negative interactions between herbs, supplements, and other medications being used. Acupuncture This is an eastern approach to healing. Acupuncture focuses on the body's energy force known as Qi or Chi. When the energy is blocked from flowing this is when physical illnesses develop. Acupuncture restores the healthy energy flow. It isn't better or worse it is just different. Herbal Medicine There are herbal compounds that have proven to be useful for neck pain. Capsaicin Cream Capsaicin is a chili pepper extract and can help relieve neck pain. It temporarily reduces pain. Capsaicin cream can help with osteoarthritis and muscle pain, which both cause neck pain. Devil's Claw Devil's claw comes from southern Africa, where it has been used for centuries to treat fever, arthritis, and gastrointestinal problems. It is used for conditions that cause inflammation and pain, like cervical osteoarthritis. White Willow Bark White willow bark is how aspirin in Europe was developed. Synthetic versions like aspirin can irritate the stomach, which is why the natural white willow bark is used instead. It helps with conditions that cause pain and inflammation like osteoarthritis. Massage Neck pain can be caused by stress, overuse, and misuse. Misuse means like sitting hunched over a computer for too long every day will take its toll. Massage helps to release tension, relieve muscle inflammation, and pain. Regular massages could help as a preventative measure. Yoga/Pilates Yoga and Pilates can increase core strength, improve balance, posture, and reduce stress. These can all help deal with neck pain/ prevent neck pain when done correctly and safely. Neck pain relief can be found with these treatments. Treatments that focus on relieving tension or stress can prove especially helpful if the pain is related to tight muscles and the physical effects of stress. These alternative treatments could work at their optimal in combination with other therapies. This is to fully address the underlying spinal condition/root cause, along with any other neck-related symptoms.
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Injury Medical Chiropractic and Functional Medicine Clinic can create a personalized stretching program to restore joint flexibility. For answers to any questions you may have, please call Dr. Jimenez at 915-850-0900 or 915-412-6677