Sports Injuries

For individuals experiencing eye problems, can acupuncture treatment help and benefit overall eye health?

Acupuncture For Eye Health

Acupuncture is an alternative medical practice that involves inserting thin needles at specific points on the body. The objective is to restore balance and health by restoring and balancing energy circulation through pathways throughout the body. These pathways, known as meridians, are separate from nerve and blood pathways.

• Studies have shown that the insertion of needles manipulates local accumulations of certain neurotransmitters by nearby nerves, which causes beneficial health effects of acupuncture. (Heming Zhu 2014)
• Scientists are not sure exactly how acupuncture works, but it has been shown to provide pain relief and alleviation of cancer treatment nausea. (Weidong Lu, David S. Rosenthal 2013)
• Studies have shown that acupuncture can help treat eye conditions like dry eye syndrome. (Tae-Hun Kim et al., 2012)

Eye Problems

For some individuals, a body imbalance can be caused by eye problems or disease. With acupuncture, imbalance-causing symptoms are addressed. Acupuncture promotes the circulation of energy and blood around the eyes.

• Acupuncture has been used as an alternative treatment for chronic dry eye syndrome. (Tae-Hun Kim et al., 2012)
• Studies have shown acupuncture helps reduce the eye surface's temperature to reduce the evaporation of tears.
• The procedure is also sometimes used to treat glaucoma.
• Glaucoma is an optic nerve disease usually caused by above-normal eye pressure levels.
• One study found eye pressure significantly decreased after acupuncture. (Simon K. Law, Tianjing Li 2013)
• Another study showed successful reduced allergic and inflammatory eye disease symptoms. (Justine R. Smith et al., 2004)

Eye Acupoints

 The following acupoints are for eye health.

Jingming

• Jingming - UB-1 is located in the inner corner of the eye.
• This point is thought to increase energy and blood and to help with problems such as blurry vision, cataracts, glaucoma, night blindness, and conjunctivitis. (Tilo Blechschmidt et al., 2017)

Zanzhu

• The Zanzhu point - UB-2 is in the crease at the inner end of the eyebrow.
• This acupoint is used when individuals complain of headaches, blurred vision, pain, tearing, redness, twitching, and glaucoma. (Gerhard Litscher 2012)

Yuyao

• Yuyao is in the middle of the eyebrow, above the pupil.
• This point is used for treating eye strain, eyelid twitching, ptosis, or when the upper eyelid droops over, cloudiness of the cornea, redness, and swelling. (Xiao-yan Tao et al., 2008)

Sizhukong

• The Sizhukog - SJ 23 area is in the hollow area outside the eyebrow.
• It is thought to be a point where acupuncture can help with eye and facial pain, including headaches, redness, pain, blurred vision, toothache, and facial paralysis. (Hongjie Ma et al., 2018)

Tongzilia

• The Tongzilia - GB 1 is located on the outside corner of the eye.
• The point helps brighten the eyes.
• Acupuncture also helps treat headaches, redness, eye pain, light sensitivity, dry eyes, cataracts, and conjunctivitis. (GladGirl 2013)

Early studies with acupuncture have shown promise for improving eye health. Individuals considering acupuncture are recommended to consult their primary healthcare provider to see if it can be an option for those who have not found a resolution by traditional means.

Neck 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 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

Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. https://doi.org/10.1089/acu.2014.1057

Lu, W., & Rosenthal, D. S. (2013). Acupuncture for cancer pain and related symptoms. Current pain and headache reports, 17(3), 321. https://doi.org/10.1007/s11916-013-0321-3

Kim, T. H., Kang, J. W., Kim, K. H., Kang, K. W., Shin, M. S., Jung, S. Y., Kim, A. R., Jung, H. J., Choi, J. B., Hong, K. E., Lee, S. D., & Choi, S. M. (2012). Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops). PloS one, 7(5), e36638. https://doi.org/10.1371/journal.pone.0036638

Law, S. K., & Li, T. (2013). Acupuncture for glaucoma. The Cochrane database of systematic reviews, 5(5), CD006030. https://doi.org/10.1002/14651858.CD006030.pub3

Smith, J. R., Spurrier, N. J., Martin, J. T., & Rosenbaum, J. T. (2004). Prevalent use of complementary and alternative medicine by patients with inflammatory eye disease. Ocular immunology and inflammation, 12(3), 203–214. https://doi.org/10.1080/092739490500200

Blechschmidt, T., Krumsiek, M., & Todorova, M. G. (2017). The Effect of Acupuncture on Visual Function in Patients with Congenital and Acquired Nystagmus. Medicines (Basel, Switzerland), 4(2), 33. https://doi.org/10.3390/medicines4020033

Litscher G. (2012). Integrative laser medicine and high-tech acupuncture at the medical university of graz, austria, europe. Evidence-based complementary and alternative medicine : eCAM, 2012, 103109. https://doi.org/10.1155/2012/103109

Tao, X. Y., Sun, C. X., Yang, J. L., Mao, M., Liao, C. C., Meng, J. G., Fan, W. B., Zhang, Y. F., Ren, X. R., & Yu, H. F. (2008). Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 28(3), 191–193.

Ma, H., Feng, L., Wang, J., & Yang, Z. (2018). Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 38(3), 273–276. https://doi.org/10.13703/j.0255-2930.2018.03.011

GladGirl The Lash & Brow Expert Blog. Acupuncture for Eye Health. (2013). https://www.gladgirl.com/blogs/lash-brow-expert/acupuncture-for-eye-health

Athletes and physically active individuals who participate in activities, exercises, and sports that involve kicking, pivoting, and/or shifting directions can develop pelvis overuse injury of the pubic symphysis/joint at the front of the pelvis known as osteitis pubis. Can recognizing the symptoms and causes help in treatment and prevention?

Osteitis Pubis Injury

Osteitis pubis is the inflammation of the joint that connects the pelvic bones, called the pelvic symphysis, and the structures around it. The pubic symphysis is a joint in front of and below the bladder. It holds the two sides of the pelvis together in the front. The pubis symphysis has very little motion, but when abnormal or continued stress is placed on the joint, groin and pelvic pain can present. An osteitis pubis injury is a common overuse injury in physically active individuals and athletes but can also occur as the result of physical trauma, pregnancy, and/or childbirth.

Symptoms

The most common symptom is pain over the front of the pelvis. The pain is most often felt in the center, but one side may be more painful than the other. The pain typically radiates/spreads outward. Other signs and symptoms include: (Patrick Gomella, Patrick Mufarrij. 2017)

• Lower abdominal pain in the center of the pelvis
• Limping
• Hip and/or leg weakness
• Difficulty climbing stairs
• Pain when walking, running, and/or shifting directions
• Clicking or popping sounds with movement or when shifting directions
• Pain when lying down on the side
• Pain when sneezing or coughing

Osteitis pubis can be confused with other injuries, including a groin strain/groin pull, a direct inguinal hernia, ilioinguinal neuralgia, or a pelvic stress fracture.

Causes

An osteitis pubis injury usually occurs when the symphysis joint is exposed to excessive, continued, directional stress and overuse of the hip and leg muscles. Causes include: (Patrick Gomella, Patrick Mufarrij. 2017)

• Sports activities
• Exercising
• Pregnancy and childbirth
• Pelvic injury like a severe fall

Diagnosis

The injury is diagnosed based on a physical examination and imaging tests. Other tests may be used to rule out other possible causes.

• The physical exam will involve manipulation of the hip to place tension on the rectus abdominis trunk muscle and adductor thigh muscle groups.
• Pain during the manipulation is a common sign of the condition.
• Individuals may be asked to walk to look for irregularities in gait patterns or to see if symptoms occur with certain movements.

1. X-rays will typically reveal joint irregularities as well as sclerosis/thickening of the pubic symphysis.
2. Magnetic resonance imaging - MRI may reveal joint and surrounding bone inflammation.
3. Some cases will show no signs of injury on an X-ray or MRI.

Treatment

Effective treatment can take several months or longer. Because inflammation is the underlying cause of symptoms, the treatment will often involve: (Tricia Beatty. 2012)

Rest

• Allows the acute inflammation to subside.
• During recovery, sleeping flat on the back may be recommended to reduce pain.

Ice and Heat Applications

• Ice packs help reduce inflammation.
• The heat helps ease pain after the initial swelling has gone down.

Physical Therapy

• Physical therapy can be extremely helpful in treating the condition to help regain strength and flexibility. (Alessio Giai Via, et al., 2019)

Anti-inflammatory Medication

• Over-the-counter nonsteroidal anti-inflammatory medications - NSAIDs like ibuprofen and naproxen can reduce pain and inflammation.

Assistive Walking Devices

• If the symptoms are severe, crutches or a cane may be recommended to reduce stress on the pelvis.

Cortisone

• There have been attempts to treat the condition with cortisone injections, but the evidence supporting its use is limited and needs further research. (Alessio Giai Via, et al., 2019)

Prognosis

Once diagnosed, the prognosis for full recovery is optimal but can take time. It can take some individuals six months or more to return to pre-injury level of function, but most return by around three months. If conservative treatment fails to provide relief after six months, surgery could be recommended. (Michael Dirkx, Christopher Vitale. 2023)

Sports Injuries Rehabilitation

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

Gomella, P., & Mufarrij, P. (2017). Osteitis pubis: A rare cause of suprapubic pain. Reviews in urology, 19(3), 156–163. https://doi.org/10.3909/riu0767

Beatty T. (2012). Osteitis pubis in athletes. Current sports medicine reports, 11(2), 96–98. https://doi.org/10.1249/JSR.0b013e318249c32b

Via, A. G., Frizziero, A., Finotti, P., Oliva, F., Randelli, F., & Maffulli, N. (2018). Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature. Open access journal of sports medicine, 10, 1–10. https://doi.org/10.2147/OAJSM.S155077

Dirkx M, Vitale C. Osteitis Pubis. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556168/

When dealing with any kind of pain, many types of remedies can help alleviate the source of the pain. Whether muscle pain or cardiac tissue pain, the effects can be long-term if not appropriately treated. Doctors have discovered that low laser therapy can help repair injured muscles that patients have experienced. With low laser therapy, the beneficial effects can help repair injuries that the bodies’ skeletal and cardiac muscles have endured. 

When the body gets injured, many people endure the pain later or during the accident. Sometimes the pain is short-termed or long-termed, depending on how severe the injury is. Short-term pain or “acute” pain can be simple, like a sprained joint; however, long-term pain or “chronic” pain, it’s more severe to the body and can have lasting effects. Chronic pain can hinder a person’s body from doing the most straightforward task. When people deal with chronic pain, it can drastically affect the body’s musculoskeletal system and even their cardiovascular system. 

When the body’s musculoskeletal system is damaged, many complications can start affecting the joints in many different parts of the body. Chronic pain can cause inflammation throughout the body, causing a person not to have the energy to do any task they planned for the day. Sometimes the pain can be excruciating where the body just completely shuts down. When doctors see their patients, they ask them, “Where does it hurt?” meaning where the pain feels more excruciating on the person’s body. The patient will always tell their physicians that the pain is on their joints or back. So doctors would recommend low laser therapy.

With low laser therapy or phototherapy, the effects from the treatment can alleviate the pain from the body. Studies show that the application of low laser therapy in injured muscles can significantly enhance muscle regeneration in multiple and frequent applications. Low laser therapy does target the injured muscles because it uses irradiation, which targets the affected muscle while increasing the body’s natural antioxidants and cytoprotective heat shock proteins (HSP-70i). Phototherapy can even help reduce muscle fatigue in athletes when they are in a post-exercise routine.

Studies have found that physical therapists use phototherapy as another form of recovery treatment for athletes. What the laser does is that when it is placed on the affected muscle and joint pain, the infrared wavelength penetrates the skin and starts to affect the targeted area. The infrared wavelengths cause therapeutic effects by decreasing oxidative stress accumulated by the body while also reactivating oxygen species production, improving the body’s mitochondrial function, etc. Another study also shows that phototherapy can also repair cardiac tissue. The study shows that when doctors use phototherapy, it directly affects the intracellular mechanisms in the heart while also activating heat-independent tissues without causing tissue damage to the heart. The study also shows that phototherapy can be effective in various complications, such as lymphoedema and muscular trauma. 

All in all, low laser therapy has beneficial properties in preventing muscle and cardiac muscle tissue damage. Its infrared radiation can help patients go about their day without the pain and suffering that their body endures. By reducing ventricular dilatation and preserving the body’s mitochondria while elevating the HSP-70i, the body can start on the road to recovery.

References:

Leal Junior, Ernesto Cesar Pinto, et al. “Effects of Low-Level Laser Therapy (LLLT) in the Development of Exercise-Induced Skeletal Muscle Fatigue and Changes in Biochemical Markers Related to Postexercise Recovery.” Journal of Orthopaedic & Sports Physical Therapy, Aug. 2010, https://www.jospt.org/doi/10.2519/jospt.2010.3294.

Kazemi Khoo, Nooshafarin, et al. “Application of Low-Level Laser Therapy Following Coronary Artery Bypass Grafting (CABG) Surgery.” Journal of Lasers in Medical Sciences, Laser Application in Medical Sciences Research Center, 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291821/.

Oron, Uri. “Photoengineering of Tissue Repair in … – Medical Laser.” Photoengineering of Tissue Repair in Skeletal and Cardiac Muscles, 2006, http://medical.summuslaser.com/data/files/91/1585172203_ls8S6pcJwigZfZQ.pdf.

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*

Although many soccer injuries involve the legs and lower extremities, other body areas are susceptible to injury/s. Acute or cumulative is how soccer injuries are generally described. Acute injuries are traumatic. They are usually caused by a slip, trip, and fall, getting hit, and crashing into other players. Cumulative injuries involve repetitive stress on a muscle, joint, or connective tissue. This triggers progressive aches, pain, and physical impairment that gets worse with time. Understanding how and why they happen is the first step in injury prevention. The more common injuries experienced among soccer athletes include.

Concussion

This is a form of mild traumatic brain injury mTBI caused by a sudden hit/impact to the head. Players are trained to head the ball; however, concussions can happen if not ready for impact or heading at an awkward position.

Ankle Sprains

Ankle sprains are when there is stretching and tearing of ligament/s that surround the ankle joint.

• Lateral ankle sprains or outside of the ankle can happen when a player kicks the ball with the top of the foot.
• A medial ankle sprain or inside of the ankle can happen when the toes are turned out when the foot is flexed up.

Achilles Tendonitis

This is a chronic injury that occurs from overuse with pain in the back of the ankle. Players are constantly performing repetitive and sudden movements that, over time, can cause this type of injury.

Achilles Tendon Rupture

A rupture involves a partial or complete tear of the Achilles tendon. Often players say with a popping sound. This happens when players perform fast, explosive movements. Rapid stopping, starting, shifting, jumping can all contribute.

Groin Pull/Strain

This is a type of strain that happens when the inner thigh muscles are stretched beyond their limit. As a result, a player can pull the groin when kicking and/or resistance from an opponent trying to take the ball or kick in the opposite direction.

Hamstring Injury

These injuries involve the three back muscles of the thigh and can vary from minor strains to complete ruptures/tears. This comes from running, sprinting, jumping, and stopping, leading to these types of injuries.

Iliotibial Band Syndrome

This is an overuse/repetitive injury that involves a tendon known as the IT band. This is the connective tissue that runs along the outside of the thigh. Constant running can create friction as the band gets pulled along the outside of the knee, which can cause tendonitis.

Plantar Fasciitis

This causes foot pain caused by inflammation of the tissue bands that run from the heel to the toes. Several factors can cause the condition. This could be players using inappropriate or not correctly fitting shoes, shoes that do not provide proper arch support or playing on a hard surface.

Calf Muscle Pull

This is when one of the muscles of the lower leg gets pulled from the Achilles tendon. Again, quick and spontaneous sprinting, running, or jumping is usually the cause.

Knee Injuries

The most common soccer injuries are those that involve the knee. This is because of the stopping and shifting directions quickly and suddenly. The explosive, spontaneous movements place extreme stress on the knees and the supporting ligaments. When the stress goes beyond the ligament's limits, it can cause a sprain or tear in the joint. When there is an injury to the knee/s, it is diagnosed using a grading scale. 

• Grade 1 Mild sprain
• Grade 2 Partial tear
• Grade 3 Complete tear

Runner's Knee

Patellofemoral pain syndrome, also known as runner's knee, is a condition where the cartilage under the kneecap gets damaged from an injury or overuse. This happens when there is a misalignment in the knee and/or strained tendons.

ACL Injury

The anterior cruciate ligament or ACL is at the front of the knee. These are the most common knee injuries. This is because the ligaments are less retractable than muscles or tendons. And those in the knees are highly vulnerable to damage.

Cruciate Ligament Injury

This type of injury does not always cause pain but often causes a popping sound when it happens. Pain and swelling develop within 24 hours. This is followed by the loss of range of motion and tenderness around and along the joint.

Meniscus Injury

The Meniscus involves a C-shaped piece of cartilage that cushions the space between the femur and the shin bone. These tears are painful and are often the result of twisting, pivoting, decelerating, or quick/rapid impact.

Shin Splints

The term describes a variety of painful symptoms that develop in the front of the lower leg. This often happens from over/intense training, or the training gets changed. Players can also develop shin splints from training while not using appropriate shoes.

Stress Fractures

These types of fractures are usually the result of overuse or repeated impact on a bone. The result is severe bruising or a slight crack in the bone.

Tendonitis

When tendons get inflamed, it is referred to as tendonitis. This comes with repetitive overuse but can also develop from a traumatic injury that causes micro-tears in the muscle fibers.

Soccer Injuries Prevention

These injuries result from overuse, overtraining, improper conditioning, and/or not warming up properly. Here are few tips to help reduce the risk.

Warm-up for at least 30 minutes before playing

Pay special attention to stretching the:

• Groin
• Hips
• Hamstrings
• Achilles' tendons
• Quadriceps

Wear protective gear

This includes:

• Mouthguards
• Shin guards
• Kinesio tape
• Ankle supports
• Eye protection
• Ensure they are correctly sized and maintained.

Check the field

Check for anything that could cause injury/s. This includes:

• Holes
• Puddles
• Broken glass
• Stones
• Debris

Avoid playing in bad weather

Or immediately after heavy rain when the field is especially slick and muddy.

Allow enough time to heal after an injury.

This also goes for minor soccer injuries. Trying too fast to get back increases the risk of worsening the injury, re-injury, and/or creating new injuries.

Body Composition

Athletes and Carb Loading

Carb loading is a strategy that athletes use.

Endurance athletes

Utilize carb-loading to help them increase energy storage for long runs, bike rides, swims, etc. When timed effectively, carb-loading has been shown to increase muscle glycogen, leading to improved performance.

Bodybuilders and fitness athletes

Use carbo-loading to build size and mass before competitions. The timing and efficacy of carb-loading vary from person to person. Make sure to experiment before the next big competition.

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Fairchild, Timothy J et al. “Rapid carbohydrate loading after a short bout of near maximal-intensity exercise.” Medicine and science in sports and exercise vol. 34,6 (2002): 980-6. doi:10.1097/00005768-200206000-00012

Kilic O, Kemler E, Gouttebarge V. The "sequence of prevention" for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature. Phys Ther Sport. 2018;32:308-322. doi:10.1016/j.ptsp.2018.01.007

Lingsma H, Maas A. Heading in soccer: More than a subconcussive event?. Neurology. 2017;88(9):822-823. doi:10.1212/WNL.0000000000003679

Pfirrmann D, Herbst M, Ingelfinger P, Simon P, Tug S. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review. J Athl Train. 2016;51(5):410–424. doi:10.4085/1062-6050-51.6.03

One of the most likely causes of foot/heel pain is inflamed plantar fascia, which causes plantar fasciitis. It can be a painful and common injury from overuse of the ligaments in the foot. When this pain presents, it can make an individual not want to walk or place any type of pressure on the feet, as the pain worsens with pressure or impact on the foot.

Chiropractic care doesn’t just treat the spine but can help with various other musculoskeletal issues throughout the body. With chiropractic adjustments, rest, icing, and exercises, the ligaments, and tissues of the feet are worked out, massaged, and stretched back to their normal range.

Plantar Fascia

There is a ligament called the plantar fascia. It runs along the bottom of the foot and connects the toes to the heel. The plantar fascia absorbs shock and helps support the feet when walking. However, ligament tension can begin to increase, specifically when standing for long periods. When the tension reaches its limit, small tears can begin to form along with inflammation causing pain.

The pain occurs when walking, standing, or immediately after waking up. The condition can happen to anyone but is more likely to become an issue for those who stand or walk as a regular part of their job, home activity, etc. Side effects from the foot pain often cause individuals to adjust their walking gait to avoid feeling discomfort, that stresses the rest of the body like the muscles, ligaments, joints that can lead to various types of injury/s.

Chiropractic Treatment

Individuals with an inflamed plantar fascia often experience a shooting/stabbing pain that worsens in the morning or after standing or sitting for an extended time. Repetitive impact on the feet and poor arch support from shoes cause small tears to happen over time from the continued stress. If it has just started the pain can be treated with ice and rest, but they are not for solving the root cause. Chiropractic can help bring pain relief that lasts along with recurrence prevention. Here are some a few ways a chiropractor can help:

Ankle Re-alignment

• Ankle misalignment can contribute to plantar fasciitis at the plantar fascia has to work harder to move the foot without the ankle's support. Manipulation and realignment of the ankle will improve foot function.

Massage

• A chiropractor along with a physical therapy team can be utilized for soft tissue massage and trigger point therapy to release tension.

Exercises and Stretches

• Various stretching and exercising techniques can be implemented to help speed up the healing process. A chiropractor will work the individual through exercises and stretches designed to relieve inflammation and stretch out the tissue. Specific exercises will also be taught to help strengthen the lower leg muscles to stabilize the heel and help prevent pain.

Posture

• A chiropractor will correct any improper posture/s that has contributed to the foot pain or has become a way of being able to function as a result of the pain. This will return the individual to a normal gait when walking and running. Pressure on the feet and plantar fascia will be alleviated.

Spinal/Hip Re-alignment

• Individuals learn to avoid pain by walking/moving in a different way than how the body is supposed to. This results in pain in the hips and back, as the body is being pulled in various ways. Manipulation and mobilization will be used to realign the body to its proper form.

Footwear/Orthotics

• A chiropractor will make adjustments to the feet, ankles, and spine to reduce pain and relieve the pressure on the plantar fascia. Supportive footwear and orthotics could be recommended for extended/preventative care. Once diagnosed with a foot problem wearing proper shoes that support the feet is essential.
• Orthotics can also help prevent injury to the back, joints, and muscles that were stretched or over-worked from an abnormal gait. When the pressure is relieved, the ligament starts to heal. This can take a few weeks. The result is a healthier heel/foot with proper function. Chiropractic can accelerate the healing process combined with home care. If pain is presenting in the heel, do not delay and focus on healing the foot.

Walking Incorrectly

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*

References

Goff, James D, and Robert Crawford. “Diagnosis and treatment of plantar fasciitis.” American family physician vol. 84,6 (2011): 676-82.

Chiropractor, Dr. Alex Jimenez looks at tendon injury -- as well as the ways in which these conditions have been diagnosed And handled...

Tendons are bands of tough connective tissue that connect muscles to bones. They conduct the force produced by the muscle to move the bone hence they need to be strong enough to endure the transmission of forces, yet flexible enough to, on occasion, act as pulleys around bony prominences. Collagen, a protein found in the extracellular matrix (ECM) of connective tissue, provides tendons their tensile strength and permits them to be stretched without breaking up. Collagen molecules bind together to form a microfibril, and microfibrils combine one another to make a collagen fibre (see Figure 1). Collagen fibers make a bundle up, and fibre bundles joined together are known as a tendon fascicle.

The fiber tendon fascicles and bundles are sheathed in a thin layer of connective tissue called the endotenon. The endotenon enables the packages and fascicles to move independently of one another, slipping against each other as required to adjust to push and the angle between the bone and the muscle. The endotenon is a continuation of this tissue that encircles the entire tendon, known as the epitenon. Some joints have an additional covering called the peratenon, which, while working with all the tendon, is a arrangement.

The tenocyte, the regulatory mobile within the tendon, modulates the assembly of the collagen inside the tendon and also the secretion of the extracellular matrix. Tenocytes lie in long rows across the collagen fibers and are found in epitenon and the endotenon of this anus. The tenocytes form a connective net of projections that makes it possible for the cells to communicate with each other as the need for degradation or synthesis of collagen fibers. They activate the formation of collagen cells when they experience stresses of short duration. Prolonged tension results in hydration inhibition.

The blood supply to tendons is markedly less than that of the muscle to which they're attached. The vessels which do exist inside the thoracic are quite modest, and operate together with the fascicles within the endotenon sheath. Some regions of tendon deficiency a blood supply. These areas are particularly vulnerable to degeneration and rupture, as one might suspect.

Tendon Injury

Trainers injure their tendons due to overuse or injury. Of the 32 million musculoskeletal injuries documented in the USA annually, 45 percent of these are injuries to tendons, ligaments, or joint capsules(1). The tendons would be the joints of the rotator cuff of the shoulder, the Achilles tendon, patellar tendon, and elbow extensor tendon.

Factors that place a strain on the thoracic and lead to overuse injuries include:

• Abnormal direction of pull due to skeletal misalignment;
• Differences in limb lengths;
• Muscle fatigue or imbalances;
• Hypermobile joints;
• Inflexible muscles;
• Training mistakes;
• Faulty or improperly fitted equipment and sneakers.

Notoriously Tricky to treat, limb harm was considered as an inflammatory disease, and consequently termed tendonitis. Remedy was unsuccessful and modalities, and was aimed at reducing the inflammation. Further research revealed that acute inflammatory cells have been absent despite a disturbance to the collagen formation within an injured tendon. Tendinosis, A new term, was heralded to spell out the degenerative lesions observed in the thoracic tissue, and also the absence of inflammation. Despite the new nomenclature along with remedies to cover the degeneration of the tendon as opposed to the inflammation's accession, effective treatment of tendon dysfunction, and that we will call tendinopathy, has been evasive.

Inflammation Plays a Role

Advances in histology allow scientists to now take a closer look at the procedure for tendinopathy. Studies of wounded tendon that is human are hard due to the time a person seeks help the injury is chronic. Animal models are analyzed to reveal acute tendon changes. Researchers from Queen Mary University in London analyzed the response of the tenocytes of horse joints to cyclic loading(two). Fascicle packs from six horses were divided into treatment and control groups. Treatment samples underwent loading strain, while controls remained unloaded.

Hours after a cyclic loading Protocol, the collagen cells inside the fascicles of these tendons appeared rounded and unorganised, while the control cells had been long, thin, and aligned along the fascicle. Markers were found in the samples that were treated following their loading cycle, whereas the control samples exhibited few if any markers for inflammation. Researchers reasoned that tendon cells respond especially.

These findings are consistent with other Animal research, which find both an increase in inflammatory markers after episodes of loading or tendon damage, in addition to an increase in the number and size of their tenocytes(2). The proliferation of tenocytes is known to occur in the presence of inflammation; therefore, this reaction is seen as an artifact of a prior inflammatory cascade(3). While degeneration is seen in limb trauma, inflammation might be the instigator of those changes within the tendon during the period of tendon disease.

Further Evidence

Ultrasound examination of symptomatic tendons shows an increase in blood flow to the tendons. Tendons are lacking in blood supply, therefore, to achieve this flow, fresh blood vessels infiltrate the thoracic. This neovascularisation typically occurs in combination with an nerve alongside the blood vessel. The sprouting of new nerves inside the tendon is thought to be the origin of pain in tendinopathy.

The influx of blood flow is supposed to be evidence of degeneration in the tendon and an attempt at healing the damaged tissue. However, such neovascularization and neoinnervation could likely not occur without the presence of inflammatory mediators at some Stage(4). Researchers in Cambridge University stage to the fact Look of this tendon body of patients With tendinopathy due to overload or Harm is indistinguishable on ultrasound From those of patients with known Inflammatory diagnoses such as rheumatoid arthritis3.

Biochemical Influences

Cyclooxygenase-2 (COX-2) is an enzyme, which in the presence of nitric oxide stimulates the generation of prostanoids and produces inflammation. Studies indicate that levels of prostanoids are increased in animal tendons exposed to repeated loading(4). In tendons subjected to injected prostanoids, changes found within the tendon are consistent with tendinopathy(3). Therefore, the existence of higher levels of prostanoids in tendons that are diseased is proof of an inflammatory process within the tendon.

Substance P is a peptide secreted cells and by nerves. The presence of substance P in significant quantities in chronic tendinopathy is supposed to be the result of an inflammatory process within the tendon. Substance P causes an increase in the number of tenocytes at a tendon. Therefore, the increased variety of tenocytes observed within an injured limb may be the result of inflammatory mediators such as substance P. Substance P also increases the ratio of collagen III to hydration I molecules in the extracellularmatrix (ECM). At a tendon that is healthy, collagen I is the form found within the ECM. This change in the composition of the collagen at the ECM may well account for the difference in the form and size of the collagen and simultaneous disorganization observed in the London research(3).

Degeneration Theory

Researchers at Melbourne, Australia, developed a multi-stage version of tendon injury that encircles the current thinking on tendinosis (see Figure 2)(4).) When a tendon undergoes an increased load, it reacts by increasing the production of collagen cells and increasing its endurance to handle the greater force demand. The Australian researchers suggest this short-term proliferative but cell response that is non-inflammatory, is a reactive tendinopathy. Their idea is that the growth in cells is an attempt by the tendon better and therefore, to increase the cross-sectional area handle the load. If the load is diminished, this short-term version is reversible or the tendon has a opportunity to rest until the next stress is put on. A wholesome tendon adapts to the stress. A tendon progresses to stage two and does not recover from the strain.

At the next stage, termed thoracic disrepair, the tendon attempts to heal itself by incorporating more cells to the ECM, which raises the protein production of collagen and proteoglycans. They suggest that it's the increase in the number of proteoglycans that supplies a disorganized appearance to the ECM and affects look and the collagen composition. They note the vascularity at this phase. Their situation is that with modification of the load the composition of the ECM could be altered and healing may take place at this stage.

The final phase is degenerative tendinopathy. The hallmark of the stage is cell death, together with an ECM full of metabolic by-products vessels, and little else and regions of tendon of cells. This stage is deemed irreversible. Degenerative tendinopathy can be found as distinct lesions within a tendon. The wounded limb may display varying phases of degeneration during the tendon.

Two Sides Same Coin

What histology shows about injured tendons, in reality, is the fact that inflammatory changes and degenerative changes are both found in the same tendon(5). A group of scientists from Sweden and Italy suggested a different version for tendinopathy. Termed the "iceberg theory", this version begins with the premise that regular exercise stimulates the production of new collagen in a tendon (see Figure 3)(5). At exactly the same time, collagen degradation occurs, likely as a way of remodeling the tendon to accommodate the new load(6). Exercise stimulates the production of growth compounds and inflammatory markers, both necessary for stimulation of proliferation and degradation's wholesome tendon response. In tendons, collagen synthesis wins out in this equation as well as the fascia gets more powerful and larger.

When a tendon experiences overload or strain, the collagen fibres within the tendon start to slide past one another, breaking their rectal bonds and inducing a denaturation of the collagen. This micro-trauma is hypothesized to weaken the tendon, and impacts both the ECM and the blood source(5). The temperature inside the thoracic tissue increases. The dissipation of heat is difficult in tendons, due. The scientists theorize that it can be the hyperthermia.

Cessation of remainder, loading, and adequate blood supply are needed to heal from excess strain. Factors are generated that stimulate angiogenesis if the tendon does not have the mandatory blood supply. The look of vessels, which usually contain nerves along with the blood vessels, is considered to weaken the structure of the thoracic(5). The secretion of the two glutamate and substance P from the nerves that are sprouting contributes to tendon cell death in addition to a inflammation. It is that athletes may complain of pain and seek medical attention.

Clinical Correlation

Recognizing that there could be degenerative and inflammatory processes in chronic tendinopathy may improve treatment results. Since inflammation happens early in the course of tendinopathy, non-steroidal anti inflammatory drugs (NSAIDS) and steroid injections might be effective at the onset of pain or when the athlete first notices a 'tweaking' or strain of this tendon. Therapy and exercise both function to destroy or reduce the amount of blood vessels and nerves at the gut. In concept, by reducing the amount of vessels that are, the tendon contributes to normal and pain decreases. Eccentric exercise gets the added benefit of stimulating collagen production(4). Therapies, such as soft tissue mobilization, are thought to also stimulate collagen production and also return the ratio of type III collagen to usual to type I collagen within the ECM.

New ideas for treatments stimulate. Treatments under analysis include tissue engineering, nitrous oxide scaffolding , exogenous growth factor, platelet rich plasma injection, stem cell injection, and treatment. More study is needed to isolate which joints, at what stage of disease, respond best to which therapy. In the meantime, the recommendation would be to treat any twinge or suspicion of tendinopathy the possibility for healing is greatest and when the anti-inflammatory methods are most effective.

References
1. Birth Defects Res C Embryo Today. 2013 Sept;99(3):203-22
2. Scand J Med Sci Sports. 2014:1-11
3. Br J Sports Med. 2014;48:1553-7
4. Br J Sports Med. 2009;43:409-16
5. Arthritis Res Ther. 2009;11(3):235
6. J Anat. 2008;212:211-28

For individuals into sports, fitness enthusiasts, and those that engage in physical activities, musculoskeletal injuries are common. Can using ice tape help during the initial or acute phase of injury decrease inflammation and swelling to expedite recovery and return to activities sooner?

Ice Tape

After a musculoskeletal injury, individuals are recommended to follow the R.I.C.E. method to help reduce swelling and inflammation.  R.I.C.E. is the acronym for Rest, Ice, Compression, and Elevation. (Michigan Medicine. University of Michigan. 2023) The cold helps to decrease pain, lower tissue temperature, and decrease swelling around the site of the injury. By controlling the inflammation with ice and compression early after injury, individuals can maintain the appropriate range of motion and mobility around the injured body part. (Jon E. Block. 2010) There are different ways to apply ice to an injury.

• Store-bought ice bags and cold packs.
• Soaking the injured body part in a cold whirlpool or tub.
• Making reusable ice packs.
• A compression bandage can be used together with the ice.

Ice Tape is a compression bandage that provides cold therapy all at once. After an injury, applying it can help decrease the pain and swelling during the acute inflammatory phase of healing. (Matthew J. Kraeutler et al., 2015)

How The Tape Works

The tape is a flexible bandage that is infused with therapeutic cooling gel. When applied to an injured body part and exposed to air, the gel activates, generating a cold sensation around the area. The therapeutic medicinal effect can last five to six hours. Combined with a flexible bandage, it provides ice therapy and compression. The ice tape can be used straight out of the package but can also be stored in the refrigerator to increase the cold effect. Depending on the maker's instructions, the tape should not be stored in the freezer as this can make it too hard to wrap around the injured area.

Advantages

The benefits include the following:

Easy to Use

• The product is easy to use.
• Take out the tape, and start wrapping it around the injured body part.

Fasteners Not Required

• The wrap sticks to itself, so the tape stays in place without using clips or fasteners.

Easy to Cut

• The standard roll is 48 inches long by 2 inches wide.
• Most injuries require enough to wrap around the injured area.
• Scissors cut the exact amount needed, and store the rest in the resealable bag.

Reusable

• After 15 to 20 minutes of application, the product can be easily removed, rolled up, stored in the bag, and used again.
• The tape can be used multiple times.
• The tape begins to lose its cooling quality after several uses.

Portable

• The tape does not need to be placed in a cooler when traveling.
• It is easily portable and perfect for a quick ice and compression application immediately after an injury.
• It can decrease pain and inflammation and kept at the workplace.

Disadvantages

A few disadvantages include the following:

Chemical Odor

• The gel on the flexible wrap can have a medicine odor.
• It is not quite as powerful smelling as pain creams, but the chemical odor could bother some individuals.

Might Not Be Cold Enough

• The tape works for immediate pain relief and inflammation, but it may not get cold enough for the user when applied right from the package at room temperature.
• However, it can be placed in a refrigerator to increase the coldness and may provide a more therapeutic cooling effect, especially for those dealing with tendinitis or bursitis.

Stickiness Could Be Distracting

• The tape could be a bit sticky for some.
• This sticky factor can be a minor annoyance.
• However, it just feels sticky when being applied.
• A couple of flecks of the gel may get left behind when removed.
• The ice tape can also stick to clothing.

For individuals looking for a quick, on-the-go cooling therapy for injured or aching body parts, ice tape may be an option. It could be good to have on hand to provide cooling compression if a minor injury occurs while participating in athletics or physical activities and relief for overuse or repetitive strain injuries.

Treating Ankle Sprains

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

Michigan Medicine. University of Michigan. Rest, Ice, Compression, and Elevation (RICE).

Block J. E. (2010). Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open access journal of sports medicine, 1, 105–113. https://doi.org/10.2147/oajsm.s11102

Kraeutler, M. J., Reynolds, K. A., Long, C., & McCarty, E. C. (2015). Compressive cryotherapy versus ice-a prospective, randomized study on postoperative pain in patients undergoing arthroscopic rotator cuff repair or subacromial decompression. Journal of shoulder and elbow surgery, 24(6), 854–859. https://doi.org/10.1016/j.jse.2015.02.004

Dr. Alex Jimenez and Dr. Mario Ruja discuss how health and immunity play a role in the human body to achieve overall health and wellness.

Health and Immunity

Many studies prove that physical activity and nutrition are essentials to preventing and treating multiple chronic conditions and can prevent premature mortality. Nonetheless, more than a quarter of adults worldwide are insufficiently active and have poor eating habits. 

How do we fit physical activity into our lifestyle?

Sedentary lifestyles of modern days decrease healthspan and increase the rate of chronic diseases in our population, becoming the leading cause of morbidity and mortality and are considered at epidemic levels worldwide, making physical inactivity a leading indirect cause of death worldwide. 

When we ask people what their barriers are to working out, the most common excuses are “I don’t have the time,” ” I can’t fit it into my daily schedule.” 

Nevertheless, fitness apps and tracking devices have been out there but were not as popular as now. People were not paying much attention to these because they did not feel accountable and engaged with these workouts. 

We were close-minded into the analogy that gym equals hard, accountable workouts. 

After all the recent events in the world, we had to change many of our paradigms and discover the convenience of having technology as our ally during isolation. Thanks to technology, some things are here to stay because they are convenient and adaptable to our new necessities and lifestyle. 

Nowadays, we are back out into “the real world.” We value our time more and realize how important physical activity is for our health and emotional management.

Nowadays, the market is full of fitness and tracking apps. Choosing the right one is a challenge, as they have inexpensive rates and there is no contract attached. People can try them and jump from one to another when they get bored of the same routines. Discovering what works best for their body movement.

The benefits of working out with these gadgets are: 

Your gym is the tip of your fingers; you can do it when you have the time, you can measure your progress and always feel comfortable and in a safe environment “free of judgment,” and you don’t need any equipment to start creating the habit.

Not only has fitness been impacted by technology, but Telemedicine also offers many advantages showing positive outcomes with in-home care. Technology keeps innovating to increase the patients’ experience for at-a-distance clinical care. Wearable biometrics and activity tracking devices help us be accountable for our health goals with continuous self-monitoring and feedback; it also connects us to a new community of people with similar interests or our health practitioners for guidance. 

Studies suggest that remote health monitoring helps patients self-manage their physical activity levels. Increase the effectiveness of chronic disease home care and may reduce acute hospital use for patients. Facilitates proactive disease management and reduces hospital admissions. 

Don’t be a spectator in your health

At our office, we offer the option of online rehabilitation sessions for our patients and provide the traditional live rehabilitation session, giving them the opportunity of their time management. We want our patients to know their biometrics; using our InBody 770 body composition and water analyzer, we give them a deeper look into what is happening in their insides. Our patients stop being spectators and become actors in their healing process through education and information. Our idea is to encourage and empower our patients to handle and be active participants in reducing their inflammations and pain by practicing good eating habits and physical activity.

Healthcare will keep evolving and, with the help of technology, will transform us into active participants in our health journey and become a decision-maker in our treatments as we are 100% engaged and accountable for our bodies inside and out. With the guidance of our health practitioners, we can alter the path we will take to recover our healthspan and extend our life as moving, functional and independent human beings. Functional Medicine gives us the tools to fix ourselves through exercising and nutrition. – Adriana Caceres, Health Coach

Bibliography

Bentley1, C. L., Powell2, L., Potter1, S., Parker3, J., Mountain1, G. A., Bartlett4, Y. K., Farwer5, J., O’Connor6, C., Burns1, J., Cresswell1, R. L., Dunn1, H. D., Hawley1, M. S., 1School of Health and Related Research, & Hawley, C. A. M. S. (n.d.). The use of a smartphone app and an activity tracker to promote physical activity in the management of chronic obstructive pulmonary disease: Randomized Controlled Feasibility Study. JMIR mHealth and uHealth. Retrieved September 30, 2021, from https://mhealth.jmir.org/2020/6/e16203.

The body's muscles function to produce force and motion. The trapezius muscle is one of the largest, which makes it highly susceptible to injury/s and spasms. A trapezius muscle spasm is when the muscle starts to contract. This muscle group is based around the neck and shoulders and is used to move the scapula shoulder bone.

Causes of Trapezius Muscle Spasms

A few causes for this muscle to become inflamed/irritated include:

• Poor posture
• Injury
• Stress
• Tension
• Improper lifting

Symptoms

The effects feel similar to a pulled shoulder muscle. Common symptoms include:

• Upper body stiffness
• Shoulder pain
• Neck pain
• Arm numbness/tingling
• Lack of shoulder flexibility

Spasm and Pinched Nerve Difference

A muscle spasm and pinched nerve might seem or feel similar, but they are different. A muscle spasm makes the area tight and can cause muscle twitching. They vary in intensity with some spasms being mild and others excruciating. In some cases, a spasm can cause a nerve to get pinched if the knot contorts tightly around a nerve and if it is big enough. Conversely, a pinched nerve can also cause twitching, but it typically results in severe pain. Pinched nerves can also cause tingling sensations and numbness depending on the severity it could cause muscle spasms.

Treating The Spasms

There are a few ways to treat this naturally.

Heat and Ice Therapy

One way to calm a muscle spasm is using heat and ice. The heat will increase nerve and blood circulation keeping the muscles flexible, and the warmth will soothe the injury. This helps prevent the muscles from spazzing and generating pain. Ice therapy also increases blood circulation but the focus is on reducing inflammation. The nerves become slightly frozen which stops the tingling, significantly reducing the pain.

If pain presents around the trapezius, immediately put an ice pack on. It should be applied every few hours in 15-minute sessions. Once the pain subsides, heat therapy can be applied. A heating pad placed around the area, a warm/hot bath, or standing in the shower if possible with a massage setting letting the warm/hot water hit the muscle. But it must be consistent, doing it for about 20-minute sessions three times a day.

Stretches and Exercises

Stretches and exercises can help keep the muscle flexible and prevent any tightening.

Upper Trapezius Stretch

This stretch will move the upper trapezius area, promoting flexibility and preventing the muscle from becoming stiff.

• Sit in a chair with proper posture
• Holding onto the chair with the left hand, wrap the right arm over the top of the head so that the hand touches the left ear.
• Gently pull the head toward the right and hold.
• Slowly move the head back and repeat with the other hand.

Shoulder Shrugs

• Moving the shoulders up and down throughout the day stretches the trapezius.
• It releases tension and strengthens the muscle to protect it.
• This exercise should be done every few hours for about a minute or two.
• Also occasionally rolling the shoulders will help stretch the smaller components of the trapezius.

Cobra Pose

This yoga pose is for relieving tension.

• It can be very helpful for those suffering from severe spasms or from a pinched nerve.
• The first thing is to lie face-down on the floor.
• Keeping the feet straight behind, use the hands to gently push the upper body up so that the spine slightly curves.
• Make sure that the hands are situated in front of the body and firm on the ground.
• Hold for a few seconds and then release.
• Repeat the process three more times.

Therapeutic Massage

• The soothing motions from a massage will calm irritated areas and encourage them to heal quicker.
• At first, because of the tenderness around the area, a massage could present with pain.
• The massage therapist needs to press on the area to increase blood circulation so that toxins get flushed out.
• While it might hurt the individual soon notices that the swelling and pain are reducing.

Some massage techniques include:

• Deep tissue
• Swedish
• Sports
• Self-massage

Chiropractor

Chiropractors specialize in the musculoskeletal system and understand how the muscles, bones, and joints all work together. For muscle spasms, they investigate the problem and look at other areas of the body that could be contributing to or worsening the condition. For some, muscle spasms could be brought on by a misplaced joint pressing on the area. A chiropractor will palpate the areas to ensure this is not the case. And if there is a problem, they will perform a joint manipulation. This realigns the joint back in place and reduces muscle spasm symptoms. Over time the muscles become healthier because chiropractic releases toxins and improves the range of motion.

Body Composition

Anti-Inflammatory Diet

Often, muscle spasms are the result of inflammation. When a muscle swells, it can place pressure on surrounding nerves. The more intense the inflammation the more pressure/stress on the nerves. This can make moving and functioning very difficult because of the pain. To naturally reduce inflammation consider an anti-inflammatory diet. This type of diet is filled with antioxidants, vitamins, and minerals that will work to reduce swelling. Although it might not completely repair the muscle injury, it can reduce symptoms and stop oxidative stress. Foods to eat more of are:

• Cherries
• Tomatoes
• Almonds
• Blueberries
• Oranges
• Salmon
• Kale
• Turmeric

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*

References

Finley JE. Physical Medicine and Rehabilitation for Myofascial Pain. Medscape. https://emedicine.medscape.com/article/313007-overview#showall. Updated May 21, 2017. Accessed July 16, 2018.

Rodante JA, Al Hassan QA, Almeer ZS. Myofascial Pain Syndrome: Uncovering the Root Causes. Practical Pain Manag. https://www.practicalpainmanagement.com/pain/myofascial/myofascial-pain-syndrome-uncovering-root-causes. 2012;6. Last updated on October 5, 2012. Accessed July 16, 2018.

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.656.582&rep=rep1&type=pdf

Kinesio taping method is a therapeutic technique that offers an approach of supporting the individual and rehabilitating the condition or affected area. Kinesio tape can stimulate or relax muscles, depending on the technique and type of tension that is put on the body. It raises the skin in microscopic increments that aid in lymphatic drainage.

It decreases inflammation and swelling reducing pressure in the area, allowing the blood and lymphatic fluid to flow naturally and more effectively in and out of the affected area.

Kinesio Tape:

• Reduces inflammation
• Promotes better circulation
• Prevents injury
• Facilitates healing
• Re-educates the neuromuscular system.

This helps the body return to homeostasis. It can be applied in a variety of different configurations, but usually, applications are single:

• I
• Y
• X 

Kinesio Taping

There are unique taping shapes specialized to address certain areas of the body and conditions. Providing stability and support for the body’s joints and muscles, it does not restrict the body's range of motion. The technique\s are designed to address soft tissue injury/s by manipulating the area and promoting natural healing, alleviating pain, reducing swelling, and providing all-around relief.

Kinesio Taping can Treat

A variety of conditions benefit from Kinesio taping. Chiropractors and physical therapists use it for:

• Ankle sprains
• Back strain
• Carpal tunnel syndrome
• Herniated disc
• Lower back strain
• Patella tracking
• Plantar fasciitis
• Pregnancy
• Pre-surgery edema
• Post-surgery edema
• Rotator cuff injury
• Tennis elbow
• Whiplash

Athletes use it for additional support and injury prevention.

Taping and Chiropractic

The tape uses the body’s own natural healing process with many individuals finding it, as the preferred treatment for many conditions. When combined with chiropractic care, Kinesio Taping is highly effective. A chiropractor may use a variety of techniques, depending on the condition or injury.

They can use spinal manipulation, physical therapy, massage, electrical stimulation, ultrasound, heat, and ice, combining them with recommendations for lifestyle and diet modifications. As aforementioned it encourages the body to heal itself, thus eliminating the need for medication/s  their undesired and invasive surgery. Kinesio Taping is safe, natural, and a perfect complement to chiropractic treatment.

Foot Levelers Orthotics Reduce Low Back Pain

Chiropractor, Dr. Alexander Jimenez looks at the treatment options for tendon injuries based on the inflammation & degeneration paradigm strategy.

Tendons are bands of tough connective tissue at the ends of muscles that transfer forces between bones and muscles to move joints and maintain posture. They store kinetic energy, absorb shock, and assist in proprioception. To survive the fantastic forces placed upon them, tendons must be strong and rigid, yet flexible enough to participate in joint motion. Tenocytes, the regulatory cells inside the tendon, synthesize all of the components in the extra cellular matrix, including collagen. Collagen gives the tendon's tough yet elastic structure, through packages of molecules formed into concentric fibrous bands.

Healing in healthy tendons is divided into three stages:

1. The first response after strain is inflammation, which supplies clotting to ruptured vessels inside the fascia, and absorbs the tissue that's no longer viable.

2. At the proliferative and repair stage that follows, fibroblasts and tenocytes rush to the wound site, multiply, and also reconstruct the structure of the tendon.

3. The remodelling phase begins one to two months after injury, once the collagen fibres align in the direction of stress across the tendon. Through this procedure, tendons adapt and grow in thickness and length.

Historically, symptomatic tendons which failed to heal were assumed stuck in a cycle of inflammation and also the illness had been labelled tendonitis. Subsequent research has found evidence of degeneration in symptomatic tendons, and the inflammatory theory was then lost in favor of the expression 'tendonosis'. More recent work suggests that both degeneration and inflammation exist in failed gut healing, called tendonopathy.

Tendonopathy

When excess loads, intrinsic or extrinsic variables, inhibit the usual healing response, the tendon becomes symptomatic (see box 1). Researchers at Melbourne have called this phase 'reactive tendinopathy', and explain the proliferation of collagen within the tendon as 'non-inflammatory and short- term'(2). If the strain on the tendon remains, the fascia farther attempts to adapt by increasing the protein molecules in the extra cellular matrix and sprouting new blood vessels at the tendon, termed fig disrepair. Continued strain leads to tendon degeneration. However, if the load is modified before the tendon reaches the degenerative stage, the tendon may have the ability to recover through a normal healing response (see figure 1).

If a continuous normal load or an excessive load is applied to a tendon, and also normal adaptive processes are disrupted, the tendon begins a cascade toward degeneration. If the load is altered or there are changes in either the external or internal factors, then the limb gets the chance to start healing(two).

Anti-Inflammatory Interventions

Considering that the inflammatory part of Tendon recovery occurs after the initial strain, it's sensible to think about anti- inflammatory drugs in treating tendonopathy, particularly in the period soon after trauma. Corticosteroid injections provide short-term pain relief from pain and swelling. Some assume that the result is actually about the cells surrounding the injured tendon, rather than the tendon itself(3). Knowing that corticosteroid injections are not curative but it's important when considering their use in treatment. While enhancing comfort and operate in the short term, corticosteroids tend to weaken the construction of the tendon, ironically raising the risk of tendon rupture.

Nonsteroidal anti-inflammatory drugs (NSAIDs), administered either orally or trans-dermally also assist with pain management. Professor Jill Cook has regularly stated that using Ibuprofen (and only Ibuprofen -- maybe not Celebrex or Feldene etc.) appears to drop the pain in painful joints at the reactive phase if used short term(4). Again, some theorise that maybe the mechanism of activity is actually about the tissue surrounding the tendon. However, NSAIDs have been shown to supress tendon healing in animal research, which would indicate an immediate action upon the tendon(3). Since inflammation is a standard part of this adaptive answer, maybe inhibiting it with NSAIDs interrupts a necessary part of the recovery process.

The prolonged use of NSAIDs conveys a Risk of unwanted effects linked to the renal, cardiovascular and gastrointestinal systems along with a review of the literature provides little to substantiate their use in the treatment of tendinopathy beyond short-term pain control(3). Thus, the decision to recommend NSAIDs or not is based on clinical decision making. Consider the demand for pain management versus the potential side effects and impact on tendon healing prior to telling its use.

Healing Through Loading

Eccentric exercise is the most effective form of exercise for curing tendonopathy, although the mechanism of action is not well understood(5). During eccentric exercise (muscle lengthening), the tension within the muscle fibres is higher than when the muscles move concentrically (muscle shortening), yet the energy requirements, oxygen intake, adenosine triphosphate (ATP) breakdown, and heat generation are less than through concentric movement. Therefore, during eccentric exercise, the muscle produces exactly the exact same amount of work with less effort, and releases fewer annoying waste solutions.

Maybe There's something in this eccentric equation that allows the tendon to receive the mechanical stimulation it needs to repair, while keeping the bronchial Infection at bay. Employing the Melbourne model of degenerative tendonopathy, it's sensible to expect a stressful load, along with the modification of intrinsic and extrinsic factors, to activate a normal adaptive response(two). Studies conducted on tendonopathic Achilles and patellar tendons show great results using an eccentric training program(3).

Strategies for treatment with eccentriclLoading typically rely on the Alfredson protocol. Alfredson and colleagues conducted a milestone Swedish research that showed heavy-load eccentric calf muscle exercise to be effective in treating chronic Achilles tendinopathy(6). Since then, most research suggest an identical regimen of three sets of 12-15 repetitions, first using body weight resistance and then progressing into a 15-repetition maximum immunity, twice daily(3). Pain is tolerated throughout the exercise; however, if significant pain persists following the workout, reduce the resistance.

Physiotherapy Modalities

Physiotherapists and trainers frequently strengthen Exercise prescription with different treatment modalities. Although these may increase the abstract relaxation of the athlete, they are not curative. For instance, cryotherapy (treating ice hockey) is a standard way of reducing inflammation and controlling pain. While powerful for acute harms, its efficacy in curing chronic tendonopathy from the disrepair phase is questionable.

Question Of Blood Flow

Increased blood flow in damaged tendons, Nerves sprouting along side new blood vessels had been considered to be the cause of the pain in the rectal tendon. While some saw this increased vascularity since the body's attempt to cure and sought ways to promote it, others concluded that preventing this angiogenesis would disrupt the failed recovery cascade and also provide pain relief.

Shock Therapy

Theoretically, the administration of jolt Waves to an injured tendon causes micro trauma that stimulates blood flow. Extracorporeal shock wave treatment (ESWT) targets tissue using a single-impulse acoustic wave created using magnets, underwater electrodes, or crystals. Shock waves are uni-phasic and have a peak pressure that is nearly 1000 times larger than an ultrasound wave. Shock waves, treated as a low-energy therapy, need three weekly periods; where as, a high-energy treatment is one session which requires general or local anaesthesia.

Writers from Queen Mary University of London lately reviewed the literature Limb tendonopathy and found just 13 Studies with enough reliable data to The protocol for government Of ESWT diverse between them, further Complicating the capability to draw definite conclusions. Nevertheless, the investigators Imply that ESWT is more effective in the Therapy of patellar tendonopathy than Other conservative treatments and equivalent to Patellar tendonopathy operation. When They also imply that ESWT is much more Effective than bizarre loading; and both Effective as eccentric loading when the tendonopathy is in the midportion of this Achilles tendon. There is some evidence That when combined, ESWT and eccentric Loading supply even greater outcomes(8).

Go With The Flow

There are many different treatments that aim to boost blood circulation to the relatively avascular tendon in an endeavor to boost healing. Topical glyceryltrinitrate, administered through a topical patch, delivers nitric acid (NO) to the tendon through the epidermis. The NO is supposed to improve collagen production and increase vascularization.

Injections of platelet rich plasma, based on the subject's own blood, directly into the tendon supposes that the platelets release growth factors into the tissue that is damaged (see Andrew Hamilton's detailed article on platelet treatment elsewhere in this issue). These growth factors purportedly reduce inflammation and stimulate revascularisation and collagen production. Some have tried to inject whole autologous blood into diseased tendons with the very same targets.

All in all, the shortage of studies on the efficacy of each of the above mentioned treatments, as well as also the version in protocols, research design, and sample size make it hard to assess their effectiveness with complete confidence. In addition, some of those treatments carry with them significant risks or side effects. Professional licencing boards and government agencies vary on acceptance of those methods, including ESWT, to manage tendinopathy; clinicians should therefore carefully evaluate the pros and cons of a treatment choice before recommending its use for athletes.

Interrupting Blood Circulation

Though some treatments try to increase the blood flow to the damaged tendon others try to stop it. In sclerotherapy, a chemical agent injected into the tendon, causes thrombosis and corrosion of the newly formed vessels and nerves. Electrocoagulation utilizes a radiofrequency probe to transfer renewable energy into the diseased tendon and ruin the neovascular bundle. Injection with hypertonic glucose and lidocaine, called prolotherapy, works toward the exact same end whilst inducing an inflammatory response. The ability to test whether these remedies have the impact they intend is difficult. Studies showing their effect on pain and function are inconclusive(9,10).

Researchers in Qatar, Italy, and England contested the validity of the theory of angiogenesis (new blood vessel development) as a source of either curing or pain in a joint evaluation of the literature about the subject(7). Conflicting evidence exists as to the presence of neovessels in symptomatic Achilles tendons.

The researchers reasoned that the presence or lack of neovessels bears no significance on the diagnosis, prognosis, or magnitude of pain experienced by people with tendinopathy. Consequently, the treatments that attempt to influence neovasculature one way or another, while originally promising, may end up being ineffective with nicely designed, randomised and controlled research. Until research provides better decisions, recommendation of those treatments to athletes isn't worth the possible risks associated with them.

Surgical Options

Tendon surgery is generally considered a last resort for those who fail conservative therapy. Surgery removes the areas of diseased tendon, along with the accompanying neovascularisation, and arouses a fresh healing procedure. This is accomplished through ultrasound guided percutaneous tenotomy, occasionally called needling, or tendon debridement and repair via arthroscopic or open processes.

Success rates following surgery vary, based on the type of procedure, the tendon medicated, and the amount of injury inside the tendon. Rehabilitation and return to sport can take upwards of 12 months, based again on the sort of procedure and severity of injury. Most notably, 20 percent to 30 percent of surgical treatments fail to increase the symptoms(10).

Future Treatments

Another potential treatment is the injection of cultured tenocyte-like cells, taken from the area's own skin, into the injured tendon. These cells produce collagen and are thought to promote recovery. Preliminary studies show promise, but clinical trials are needed to confirm efficacy.

Biomaterials, constructed from naturally occurring substances, have potential benefit in treating tendinopathy. All these biomaterials mimic native limb arrangement and therefore, drive cell production prior to alignment as normal tendon. In first stages of evaluation, this kind of tendon grafting has proved beneficial in canine areas(11).

Recommendations For Clinicians

Tendonopathy is among the most difficult sporting injuries to treat, and clinicians and athletes will grasp at almost anything with promise to stop the pain and return the player to game.

Anti-inflammatory medications, used promptly following injury or the onset of symptoms, reduce pain but possibly deter healing. Physiotherapy modalities may subjectively assist with pain management but lack proof they're curative. A number of different treatments, although theoretically sound, need more research and development, and proceed with them significant risks.

Modifying the load on the tendon through bizarre exercise and providing the tendon with adequate rest through the adjustment of contributing intrinsic or extrinsic factors, gives the tendon the very best opportunity to heal itself when in the reactive and disrepair phases (see Box 2). The tendon may endure the load for a weak link in the chain; be overworked since beginning twice-a-day practices; or be strained from unnatural placement while sleeping (as the athlete's puppy insists on sleeping on the bed with its mind over the athlete's knee. Play detective until you find and remove the cause of strain. Only then will the tendon get the rest it needs and begin to heal.

References
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