Sports Specific Training

A big part of sports is avoiding and preventing injuries, as injury prevention is far better than rehabilitation and recovery. This is where prehabilitation comes in. Prehabilitation is a personalized, constantly evolving, and developing strengthening exercise program. The program aims to provide sports-specific targeted exercises and activities to maintain athletes' physical abilities and mental preparedness for their sport. The first step is for an athletic trainer, sports chiropractor, and physical therapist to examine the individual.

Prehabilitation

Everybody is different when it comes to developing an effective prehabilitation program. Every individual's program should be progressive and re-evaluated to adapt and adjust to the athlete's needs. The first step is learning to prevent injuries and following basic injury prevention protocols. Knowing what to do when the body sustains an injury, like home treatment and when it's time to see a doctor.

Athletes

Athletes of all levels are recommended to incorporate a prehabilitation program into their training. As athletes engage in their sport, their bodies adjust to the physical demands of practicing, playing, and training. Imbalances can happen naturally with normal activity but become more pronounced with each practice, game, and training session and often are the cause of injury. The repetitive movements and regular stresses can cause neuromusculoskeletal symptoms to present. This includes:

• Tightness of muscle groups.
• Pain and discomfort symptoms.
• Stabilization issues.
• Strength imbalances.

Program

A chiropractic therapist will measure the individual's range of motion and strength, biomechanics, evaluate medical history, and present health status. Individuals with an injury or a condition can also benefit from prehabilitation.

• Each program is personalized and will address total body balance, sports-specific needs, and weaknesses.
• The exercises will balance strength, coordination, range of motion, and stabilization.
• The premise is looking at and comparing movements from left to right, front to back, and upper to lower body.
• Activities can be subtle, focused exercises or a complex movement sequence to stabilize or improve a specific skill.
• Programs focus on strengthening and stabilizing the core, abdominals, hips, and back.
• Instability is common and often presents from a lack of core training, as athletes tend to focus on what parts of the body their specific sport utilizes, leaving the core without a regular training routine.
• A prehabilitation program has to be constantly updated to adjust to the individual's progress.
• Tools like foam rollers, balance boards, weights, and exercise balls are used.

Training

Prehabilitation should start before any acute or chronic injury occurs, but often it takes a few injuries for individuals to decide to get into a prehabilitation program. Depending on an athlete's training cycle, prehabilitation can be incorporated into practice or as an independent workout and become part of an athlete's training routine. A session can include the following:

• Warm-up and cool-down exercises.
• Exercises to perform while resting or waiting during practice.
• A targeted workout on specific weaknesses.
• A complete workout for days off or active rest days.
• Mini workouts for when traveling and recovery days.

For athletes, feeling challenged and motivated can be the difference between success and failure. Working with a trainer, sports chiropractor, and therapists who know sports, understand athletic needs, and communicate well, will contribute to a successful prehabilitation program.

Improving Athletic Performance

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Durrand, James et al. “Prehabilitation.” Clinical medicine (London, England) vol. 19,6 (2019): 458-464. doi:10.7861/clinmed.2019-0257

Giesche, Florian, et al. "Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review." PloS one vol. 15,10 e0240192. 28 Oct. 2020, doi:10.1371/journal.pone.0240192

Halloway S, Buchholz SW, Wilbur J, Schoeny ME. Prehabilitation Interventions for Older Adults: An Integrative Review. Western Journal of Nursing Research. 2015;37(1):103-123. doi:10.1177/0193945914551006

Smith-Ryan, Abbie E et al. "Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation." Journal of athletic training vol. 55,9 (2020): 918-930. doi:10.4085/1062-6050-550-19

Vincent, Heather K, and Kevin R Vincent. "Rehabilitation and Prehabilitation for Upper Extremity in Throwing Sports: Emphasis on Lacrosse." Current sports medicine reports vol. 18,6 (2019): 229-238. doi:10.1249/JSR.0000000000000606

Vincent, Heather K et al. "Injury Prevention, Safe Training Techniques, Rehabilitation, and Return to Sport in Trail Runners." Arthroscopy, sports medicine, and rehabilitation vol. 4,1 e151-e162. 28 Jan. 2022, doi:10.1016/j.asmr.2021.09.032

Reaching, twisting, walking, and driving are everyday activities that require upper and lower back strength. An aching back can easily affect daily activities, generate frustration, anger, and affect all-around health. The more back muscle strength an individual has, the more they can accomplish far more without injury. Immense power is not required to protect the body from a back injury. All that is needed is regular, consistent physical activity and exercise. A balance of body strength is vital for preventing injury. However, overdoing one fitness exercise or physical activity can imbalance musculature, leading to injury. Because the back/spine is the central part of the body, complete and proper care is necessary for optimal health and wellness. For individuals experiencing sore, aching, and tired muscles, here are some exercises that will help in the process.

Alternating Arm and Leg Extensions

Alternating extensions help build strength and coordination in the core areas. The back muscles increase their efficiency by creating muscle memory that supports the work shared by all the torso muscles. Upper and lower back muscles must work together to maintain a healthy balance and not overwork each other, causing strain and fatigue.

• Start by placing hands and knees on the floor with the head directly between shoulders and facing toward the floor.
• Feet are directly in line behind the buttocks and resting on the floor.
• Hips and shoulders rest above the knees and hands.
• Raise the right hand straight ahead with the arm at full length.
• At the time same time, raise the left leg straight behind the body.
• Try to keep the arm and leg as straight as possible.
• Hold for 10 seconds.
• Switch sides.
• Repeat three to eight times, depending on strength level.
• If it is difficult, a modified option is to raise the arm and leg separately.

Plank Hold

These can help build back muscles and strengthen the arms, legs, and the front torso area. Plank holds are a recommended starting point. Plank holds can be done on the elbows, palms of the hands, or closed fist hands. The key is to keep the shoulders, hips, and ankles straight like a wood plank parallel to the floor.

• Place hands and feet directly on the floor like doing a push–up.
• Toes should be on the floor.
• Keep the abdominals tight and buttocks lifted to prevent straining the lower back.
• Face straight down.
• Hold for a count of 10.
• Repeat three times.
• For those with an aching back, keeping the hips level with the shoulders could be challenging at the beginning.
• With practice, it will become easier; then, the individual is recommended to increase the length of time until 30 seconds is achieved.
• Then increase the challenge to try more than three repetitions.
• A modification for beginners is to start with the body resting on the floor, stomach down.
• Then raise the body into the start position from the floor.

Hip Raises

Hip raises help to strengthen the lower back muscles to unite and support the lower half of the body. Training the body to work cooperatively is critical for reducing the aching and pain from muscle imbalance.

• Rest the body flat on the floor, facing upward.
• Place the hands flat at the body's sides.
• Knees should be about shoulder-width apart.
• Keep the feet flat on the floor
• Pull the feet toward the buttocks.
• Look straight up.
• Raise the hips as high as possible while pressing down with the hands.
• Hold for 10 seconds.
• Complete five to eight reps.

Cross Body Standing Lateral Arm Raises

Lateral raises or side lateral raises help strengthen and tone the shoulder muscles and the upper back muscles.

• Begin with a single one-pound weight.
• Face forward.
• Stand with the feet shoulder-width apart.
• Bring the weight to rest near the left hip bone.
• Gently raise the weight across the body to arrive just above the right side with the arm at full length.
• Make sure that shoulders and hips are stationary and that only the arms move. Do not twist.
• Hold for 10 seconds.
• Repeat three to eight times.
• Switch sides.
• Modification can be done by sitting in a comfortable chair with proper posture in a chair instead of standing.
• If weights are too challenging to work with initially, complete the exercise with only the hands placed with the palms flat and together.

Aerobic Activity

This helps circulate blood throughout the body, helping to reduce muscle soreness. A few gentle and aerobic activities can include:

• Brisk walking.
• Stair climbing.
• Bicycling, elliptical, or rowing machine workout.
• Physical activity that keeps blood moving throughout the body. Examples include yoga, gardening, and dancing.

While the back is healing, go at a gentle even pace for any activity. Jerking and quickly stopping can be hard on joints and discs. When injured, the other muscles try to compensate to avoid causing a flare-up that could worsen the injury and/or create a new injury.

Aching Back Muscles

Strength-building exercises are great for preventing injury and avoiding re-injury. However, avoid overreaching or overstretching with any of the activities. Continuous aching or painful back muscles could indicate something else is occurring that could be:

• A pinched nerve.
• Shifted/misaligned discs.
• Disc herniation.
• The beginning of an arthritic condition causing inflammation.
• Back muscle tear/s.
• Pregnancy.

Body Composition

Sarcopenia - Loss of Skeletal Muscle Mass and Strenght Causes

Decreased Physical Activity

• Physical inactivity is one of the primary contributors to sarcopenia.
• Sedentariness can exacerbate the effects of sarcopenia.
• Regular resistance exercise can help maintain muscle mass and build muscular strength.

Decrease in motor neurons

• Aging is accompanied by a loss of motor neurons caused by cell death. 
• This can lead to a decrease in muscle fibers and size.
• This decrease leads to:
• Impaired performance
• Reduced functional capacity
• Decreased ability to perform everyday tasks.

Increase in Pro-inflammatory Cytokines

• Poor diet and exercise also promote the storage of visceral fat.
• This type of fat tissue produces pro-inflammatory cytokines.
• This can accelerate muscle breakdown.
• Obesity and muscle weakness are associated with high levels of pro-inflammatory cytokines.

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Alfuth, M, and D Cornely. “Chronischer lumbaler Rückenschmerz : Vergleich zwischen Mobilisationstraining und Training der rumpfstabilisierenden Muskulatur” [Chronic low back pain : Comparison of mobilization and core stability exercises]. Der Orthopade vol. 45,7 (2016): 579-90. doi:10.1007/s00132-016-3233-1

Kim, Beomryong, and Jongeun Yim. "Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial." The Tohoku journal of experimental medicine vol. 251,3 (2020): 193-206. doi:10.1620/tjem.251.193

Smith, Benjamin E et al. "An update of stabilization exercises for low back pain: a systematic review with meta-analysis." BMC musculoskeletal disorders vol. 15 416. 9 Dec. 2014, doi:10.1186/1471-2474-15-416

Suh, Jee Hyun et al. "The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial." Medicine vol. 98,26 (2019): e16173. doi:10.1097/MD.0000000000016173

When back pain presents for a prolonged period, the back muscles reduce mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.

Back muscles development

With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body's ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:

• Back muscles and core muscles increase in function and performance.
• Muscles are strengthened.
• Lean muscle mass increases.
• The range of motion of the spine increases.
• Body fat decreases.

Guidelines while using weights

It is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury when weight training. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:

• Severe pain.
• Back pain that originates from:
• Previous spinal surgery
• Tumor
• Nerve root compression
• Neurological symptoms
• Sciatica
• Spinal fracture/s
• Spinal infection/s

Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.

• Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
• Trained physical/occupational therapists and sports chiropractors can educate an individual on:
• Correct techniques
• Frequency
• Type of training that will help an individual's condition.
• Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
• After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.

Smaller weights build strength progressively

Effective ways to strengthen the spine.

• Begin with small/light weights and exercise slowly.
• Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
• It is recommended to start with:
• Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
• Simple stretches

Exercise machines can be recommended instead of free weights.

• Exercise machines can provide safe, effective, and progressive resistance to the exercises.
• The machines can help reduce/prevent injury compared to free weights.
• The machines can maintain proper support on the back and spine.

It is recommended to combine regular walking activity with a weight training program.

• Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
• This promotes healing and reduces stiffness.

Training program and benefits

Gaining the most benefits from strength training, tips to keep in mind:

• Warm up for a few minutes using heat therapy and simple stretches. 
• Try for 2 or 3 times a week for 30 minutes.
• Focus on building strength in the core muscles - back, abdominals, obliques, buttocks, and pelvic leg muscles.
• There is no need to join a gym or buy expensive equipment.
• Work out at home with small hand weights, resistance bands, and body weight.
• The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
• Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
• If back pain presents with a sustained increase, take time off or modify the strength training exercises.
• Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
• Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.

Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.

Body Composition

Carbohydrates and Muscle Growth

Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.

Carbs prevent muscle weakness.

Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.

Carbs help muscles recover after exercise.

Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.

Lee JS, Kang SJ. Strength exercise and walking affect lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.

Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050

Too much running can lead to burnout and injuries for even the most hard-core runners and running enthusiasts. Cross-training can be a great way to work through unmotivated phases. Beginners and experienced runners will hit periods when they become bored or uninspired to run. Individuals dealing with injuries need to take time off from running during recovery. Once they are healed enough to engage in physical activity, doctors, trainers, physical therapists, and sports chiropractors recommend low-impact cross-training activities, like swimming or water running/aqua jogging, to lessen the stress on the muscles and joints and help injured athletes maintain their fitness and cope with the frustration of not being able to participate.

Cross Training

Cross-training is any sport or physical activity/exercise that supplements an athlete's main sport. Whether a beginner or veteran, it balances the muscle groups because it strengthens muscles that don't get worked out and/or are used less during running. This decreases the chances of worsening the injury and prevents future injuries. Added benefits:

• Improves other areas of the body.
• Improves cardiovascular fitness.
• Cross-training can help avoid getting bored with running.
• Gives runners a mental break.
• Individuals can continue to train while letting injuries heal.

Individuals dealing with an injury may need to train more frequently as part of a rehabilitation and strength training treatment plan. A doctor, chiropractor, or physical therapist will recommend how much cross-training and type of activities will be the most beneficial for the specific injury.

Activities

Swimming

Swimming is an excellent cross-training activity because it's not weight-bearing, giving the leg muscles and joints a break.

• It builds strength and endurance and improves flexibility.
• It balances working the upper body while giving the legs a break.
• Swimming is a good way to recover after a long run.
• Helps individuals prone to running injuries or are healing from an injury.
• Relaxing and meditative.

Water Running

• Water running can help with injuries and/or be used in strength training.
• It's also a great way to run during hot and humid weather.

Cycling or Spinning

• Cycling and spin classes are low-impact.
• Provide increased cardiovascular fitness and strength.
• Exercises other muscle groups, especially the quads and glutes.

Elliptical Training

An elliptical machine provides a whole-body cardiovascular workout with the feel of cross-country skiing, stair climbing, and walking.

• The machine can be programmed to move forward or backward to work all the major muscles in the legs.
• The muscles used are similar to those used when running.
• It is a low-impact alternative when injured.

Pilates

• Pilates is a form of exercise that emphasizes core strength and flexibility.
• Pilates can help increase flexibility, reduce tight muscles, and be recommended for active recovery.

Rowing

Rowing is an excellent cardiovascular, low-impact activity.

• Strengthens the upper body, hips, and buttocks.
• Proper technique will maximize the benefits and prevent injury.

Yoga

Yoga provides some of the same benefits as strength training.

• Uses body weight as resistance to strengthen and stretch muscles.
• Improves flexibility and mobility.
• Way to relax after an intense run or workout.

Taking Time Off

Taking days off from running each week to participate in cross-training activities can help maintain motivation.

• Recreational runners can supplement three to four days of running with two to three days of cross-training.
• Competitive runners who run four to six days a week can substitute low-intensity cross-training for a light run or a rest day one to two days a week.
• It helps runners add more exercise without risking overuse injuries.
• Increases muscle strength and flexibility, and core stability.

Fitness Health

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Alves de Araújo, Maria Erivânia, et al. "The effectiveness of the Pilates method: reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students." Journal of bodywork and movement therapies vol. 16,2 (2012): 191-8. doi:10.1016/j.jbmt.2011.04.002

Baltich, Jennifer, et al. "The effects of isolated ankle strengthening and functional balance training on strength, running mechanics, postural control and injury prevention in novice runners: design of a randomized controlled trial." BMC musculoskeletal disorders vol. 15 407. 4 Dec. 2014, doi:10.1186/1471-2474-15-407

Casado, Arturo, et al. "Training Periodization, Methods, Intensity Distribution, and Volume in Highly Trained and Elite Distance Runners: A Systematic Review." International journal of sports physiology and performance vol. 17,6 (2022): 820-833. doi:10.1123/ijspp.2021-0435

Claudino, João Gustavo, et al. "CrossFit Overview: Systematic Review and Meta-analysis." Sports medicine - open vol. 4,1 11. 26 Feb. 2018, doi:10.1186/s40798-018-0124-5

Schlegel, Petr. "CrossFit® Training Strategies from the Perspective of Concurrent Training: A Systematic Review." Journal of sports science & medicine vol. 19,4 670-680. 19 Nov. 2020

Tanaka, H, and T Swensen. "Impact of resistance training on endurance performance. A new form of cross-training?." Sports medicine (Auckland, N.Z.) vol. 25,3 (1998): 191-200. doi:10.2165/00007256-199825030-00005

Neck crepitus is a grinding sound that comes from moving or rotating the neck. Usually, it is not something to worry about, as the body is a sound system that generates various noises. For example, when hungry, the stomach rumbles. After digestion, the body releases the gasses through a burp. The bones can also generate neck cracking or popping sounds with regular movements. This unusual sensation is known as crepitus.

Crepitus

Crepitus or crepitation is a scientific term that describes joint movements sounds. Sounds can include:

• Popping
• Cracking
• Snapping
• Grinding

However, crepitus can happen in any moveable joints in the body. An example could be a neck cracking or popping sound when looking over the shoulder.

Why the Neck So Susceptible

The cervical spine consists of seven segments, and each segment has multiple joints that interact with the segments above and below it. The cervical spine is a flexible system that protects the neurologic structures while maintaining head and neck stability. This flexibility and the multiple joints at each level can wear down, leading to arthritis and neck crepitus.

Other Symptoms

Neck crepitus can present without other symptoms. But it can also be associated with other severe symptoms that include:

• Neck pain
• Instability
• Weakness
• Numbness
• Diminished manual dexterity
• Difficulty walking

Risk Increases With Age

Neck crepitus can present at any age; however, the risk increases as the body ages. Some individuals may have neck crepitus symptoms more often. For example, the neck cracking or popping sounds could present just a few times a month. However, other individuals could have cracking, popping sounds daily or even throughout the day. Neck crepitus can increase or decrease in frequency. Symptoms could present for several days before the sensations stop entirely.

Possible Causes

Neck crepitus can have various causes, and multiple factors can also overlap to generate these sensations.

Articular Pressure Changes

Natural lubricating lining and fluid are found within the body's joints. Small gas bubbles can form within the synovial joints, including the facet joints. When the bubbles collapse, they are released, creating cracking noises in the joints. The sounds can happen with regular everyday movements. This also occurs when a chiropractor or physical therapist performs spinal manipulations.

Tendon or Ligament Movement

Tendons are the tissue that connects the muscles to the bones, and Ligaments connect the bones. A tendon in motion can also make noises when sliding around a bone or over another tendon or ligament. The cracking can be caused by tight tissues and muscles from aging or muscles that have become weak/deconditioned.

Bones Grinding

Osteoarthritis, known as spondylosis in the spine, can cause the facet joints that connect the vertebrae to degenerate. The protective cartilage wears down, and the vertebral bones start to rub against each other. This can produce a grinding noise. However, the grinding can result from disc degeneration, which reduces the cushioning between the vertebrae.

When to Consult A Physician

If neck crepitus presents without other symptoms, it's usually not serious. When neck crepitus presents with other symptoms, it is recommended to contact a doctor. These symptoms include:

• Neck pain
• Weakness
• Sensory changes

If pain spreads out and runs down the arm or there is difficulty completing fine motor tasks like writing your name or getting dressed, consult a doctor. These symptoms can be caused by spinal cord or nerve root compression. Sometimes, neck crepitus can show up after a different health issue. For example, if an individual notices neck sounds weeks after cervical spine surgery, the spine surgeon can determine if the two are connected. A recent fall or car accident could also cause symptoms to present. If the crepitus presents almost every time with joint movement, there could be compromised joint function.

Treatment and Prevention

There are various treatment options for neck crepitus. It is recommended to start with conservative treatment like physical therapy and chiropractic pain management. Imaging scans are necessary to see if there are signs of compression on the spinal cord or nerves. Treatment objectives are to remove the pressure from the neural structures and restore the spine's stability. Cervical traction is another form of treatment. Consult a physician, spine specialist, or chiropractor to properly diagnose the issues, figure out what is going on, and develop a personalized treatment plan if necessary.

Body Composition

Sugar Replacements

Sugar substitutes can help with weight control and diabetes by allowing individuals to eat sweets without raising blood sugar levels. Sugar replacements are additives that add sweetness to food without the calories of sugar. Some sugar substitutes are synthetically made, while others are natural. Sugar replacements include:

Sucralose

• This artificial sweetener comes from sucrose and contains no calories. It is highly sweeter than sugar and can be found in grocery stores.

Fructose

• This sweetener comes in crystalline form or high-fructose corn syrup, which is often used for baking. Fructose is sweeter than sugar and has been linked to early diabetes.

Stevia

• This sweetener is extracted from the stevia rebaudiana plant species. It is calorie-free and can help manage and improve cholesterol levels.

Aspartame

•  Only a tiny amount is necessary, as this artificial sweetener is 200 times sweeter than sugar. It contains four calories per gram.
• Aspartame has been associated with cancer, dementia, and depression. But research has not found a direct correlation, and currently, recommended amounts are safe to consume.

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Mohamad, I et al. “Swollen neck and crepitus after bouts of cough.” Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia vol. 8,3 49-50. 31 Dec. 2013

Nguyen, Andrew B et al. “Crepitus: an uncommon complication of a common procedure.” The Annals of thoracic surgery vol. 91,4 (2011): e63. doi:10.1016/j.athoracsur.2011.01.031

The core and the muscles involved are a group of muscles that wrap around the body's torso. The front, back, and sides. Strengthening these muscles will improve and ultimately alleviate lower back pain. One of the main muscles that are overlooked is the transverse abdominis muscle. It is vital to a healthy core, especially if back pain is presenting. It's known as the seatbelt muscle as it is deep in the abdomen and wraps around the waist. It has everything to do with long-term core strength and function. A properly developed transverse abdominus functions like a lumbar support belt that protects the spine. When the transverse abdominus is strong the muscle contracts to generate the correct amount of support and stability when in motion.

For example, individuals that do not have low back pain engage the transverse abdominus around 30 milliseconds before moving the shoulder, while individuals that have low back pain have a delayed contraction of the transverse abdominus muscles that makes them take on awkward postures, and move in an awkward fashion contributing to back pain and continuing to weaken the core muscles. Individuals that regularly do transverse abdominus strengthening exercises greatly reduce the risk of experiencing low back pain for the first time and reduce the recurrence of those already with back pain.

Core Muscle Anatomy

The first step to strengthening is understanding the moves and how to do them correctly with basic anatomy. Think of the core as a muscle box where the:

• The front is the abdominals
• The back is the spinal stabilizing muscles
• The base is the pelvic floor
• The top is the diaphragm
• The sides are the hip muscles

The core moves in three ways:

• The body flexes and extends whenever bending forward and standing up
• The body does a lateral side bend when bending the trunk to one side
• The body rotates the trunk when twisting the torso

Muscle Weakness

The transverse abdominus tends to suffer from neglect which is one reason why it becomes weakened. This increases the risk of developing back pain. Another reason is that individuals have a weak muscle is they exercise in one-plane of movement. Not working out the core muscles in all planes of motion can contribute to back pain. For example, if an individual performs pelvic tilts, they are only moving in one plane when tilting the hips forward and back, known as flexion and extension. To achieve optimal/functional strength, the core workout needs to include side bending and twisting movements.

Strengthening The Transverse Abdominus

Pigeon Pose

Many individuals sit for extended amounts of time and are excessively tight along the sides and hips. The first step should be to increase the hip's mobility before strengthening the core. If the hip muscle's fibers become shortened, it can affect hip joint function and efficiency during core movement. The Pigeon Pose is a hip opener. How to do it:

• Get on the floor with the knees and palms on the ground.
• Slide the left leg back so the hip is extended, then externally rotate the right hip/turn the right leg out from the hip. Focus on positioning the right shin perpendicular to the body.
• Extend the trunk so the body is upright, lifting the chest, arching the back, and looking toward the ceiling, while resting the fingertips on the floor a little forward of the hips.
• Hold the pose for 30 seconds and switch sides.
• This stretches the hip flexor muscles in the extended leg and the rotator and outer hip muscles in the flexed leg.

Pay Attention To The Engaged Muscles

Individuals can train the transverse muscles to activate faster and more effectively throughout the day by slowing down and paying attention to moving with more intent. Place the hands around the waist and engage the core to feel the muscles contracting. This will help get a feel for the movement. Once comfortable remember to engage these abdominal muscles before and while reaching, twisting, or lifting items.

Pelvic Tilt

This exercise is vital for building the smaller muscles that support a healthy core. How to do it:

• Lie on back with knees bent and feet on the floor.
• Engage the transverse muscles and gently tilt the pelvis upward.
• Return the pelvis to a neutral position.
• Repeat.
• Start with 3 sets of 10-12 reps.

When this is no longer challenging and can be completed without increasing back pain, advance to more challenging exercises like the bird dog, planks, or plank variations.

Standing Exercises

Translating core strength into functional strength and pain-free movement progresses to standing exercises that require rotation. One example is a standing lunge with rotation. How to do it:

• Get into a lunge stance with the front leg flexed 90 degrees at the hip, knee, and ankle. The rear leg should be extended at the hip with the knee touching or almost touching the floor.
• Twist from the waist. When comfortable doing this movement, hold weight like a dumbbell, medicine ball, or gallon jug of water in both hands, and gradually increase the weight as the muscles get stronger.

When in the process of strengthening the core, consistency is the key. Commit to a short workout every day instead of one massive workout once or twice a week. Ten minutes a day is enough to build strength, improve function, and decrease back pain.

Improved Body Composition

Functional fitness and the ability to move about comfortably not only benefit physical wellness but also improves body composition. The aging process reduces the metabolic rate, which leads to increased body fat. Lean Body Mass gets lost from age and inactivity. Lean Body Mass contributes to the overall Basal Metabolic Rate, also known as the body's metabolism. It is the number of calories the body needs to support essential functions. Engaging in strength training or resistance exercises will help regain the muscle loss from aging/inactivity, and can lead to an increase in lean body mass.

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

People who regularly engaged in TVA-strengthening exercises were less likely to experience a recurrence of low back pain: Australian Journal of Physiotherapy (2002), “Specific spinal exercise substantially reduces the risk of low back pain recurrence” https://www.sciencedirect.com/science/article/pii/S000495141460283X?via%3Dihub