Care is the cornerstone of our practice

Give us a Call
+1 (915) 412-6680
Send us a Message
support@chiromed.com
Opening Hours
Mon-Thu: 7 AM - 7 PM
Fri - Sun: Closed

Empower your performance with expert sports therapy for athletes in El Paso, TX. Our specialists provide personalized treatment plans designed to enhance strength, recovery, and injury prevention. Whether you’re a professional or amateur, we offer cutting-edge therapies that help you stay at the top of your game. Optimize your training and performance—book your consultation today and experience the best in sports therapy for athletes in El Paso

Peroneal Tendon Injuries and Their Symptoms

Are individuals with high foot arches or participating in sports involving repetitive ankle motion at risk for developing peroneal tendon injuries?

Peroneal Tendon Injuries

The peroneal tendons connect the muscles of the outer side of the lower leg to the foot. They may be acute—occurring suddenly—or chronic—developing over time. The basic types of peroneal tendon injuries are tendonitis, tears, and subluxation. 

Anatomy and Function

The two major peroneal muscles (peroneus longus and peroneus brevis) are outside the lower leg, next to the calf muscles. The peroneal tendons run along the outer side of the ankle and attach to the foot, connecting these muscles to bone. They help stabilize the ankle joint, point the foot downward (plantarflexion), and turn the foot outward (eversion). In normal gait, the motion of the peroneal muscles is balanced by the muscles that invert the foot or rock the foot inward from the ankle.​ The two peroneal tendons sit one on top of the other right behind the fibula (the smaller lower leg bone). This closeness can contribute to problems with the peroneal tendons, as they rub together behind the ankle.

Tendonitis

The most common problem is inflammation or tendonitis. The tendons are usually inflamed just behind the fibula bone at the ankle joint. This part of the fibula is the bump on the outside of the ankle, and the peroneal tendons are located just behind that bony prominence. Tendonitis can either result from repetitive overuse or an acute injury. Common symptoms of tendonitis include:

  • Pain behind the ankle
  • Swelling over the peroneal tendons
  • Tenderness of the tendons
  • Pain usually worsens if the foot is pulled down and inwards, stretching the peroneal tendons.
  • X-rays of the ankle are taken.
  • MRI may show inflammation and fluid around the tendons. (Walt J. & Massey P. 2023)

Typical treatment of peroneal tendonitis is accomplished by:

Ice application

  • Applying ice to the area can help reduce swelling and control pain.

Rest

  • Resting is important to allow the tendon to heal.
  • A supportive device (walking boot or ankle brace) or crutches can help in severe cases.
  • Braces and boots provide support, reduce tendons’ stress, and allow rest and inflammation to subside.

Anti-inflammatory Medications

  • Motrin or Aleve are anti-inflammatory and can reduce the swelling around the tendon.

Physical Therapy

  • Physical therapy can help restore normal ankle joint mechanics, help with swelling and pain relief, and correct strength imbalances.

Cortisone Injections

  • Cortisone injections are low-risk if administered to the area around the tendon and not more often than every three months.
  • Ultrasound guidance can help ensure the medication is injected into the correct area. (Walt J. & Massey P. 2023)

Tendon Tears

Tears can occur and are more likely to happen in the peroneus brevis tendon. Tears are believed to be the result of two issues with the tendon. One is the blood supply. Tears of the peroneus brevis tendon almost always occur in the area where the blood supply and nutrition of the tendon are the poorest.

The second issue is the closeness between the two tendons, causing the peroneus brevis tendon to be wedged between the peroneus longus tendon and the bone. (Saxena A., & Bareither D. 2001) Tears of the peroneus brevis tendon are often treated with the same treatments for tendonitis. About half of the tears diagnosed by imaging are found to be asymptomatic. For individuals who don’t find lasting relief from symptoms, surgery may be necessary. Surgical options for peroneal tendon tears (Dombek M. F. et al., 2001)

Tendon Debridement and Repair

  • During a tendon debridement, the damaged tendon and the surrounding inflammatory tissue are removed.
  • The tear can be repaired, and the tendon can be tubularized to restore its normal shape.

Tenodesis

  • A tenodesis is a procedure where the damaged area of the tendon is sewn to the normal tendon.
  • In this case, the damaged segment of the peroneal tendon is removed, and the ends left behind are sewn to the adjacent remaining peroneal tendon.
  • Tenodesis is often recommended for tears involving more than 50% of the tendon. (Castilho R. S. et al., 2024)

Depending on the surgical procedure, Recovery after surgery can take several weeks of restricted weight-bearing and immobilization. Following immobilization, therapy can begin. Recovery is usually six to 12 weeks, depending on the surgery, but a full return to sports and activities may take several months. Risks of surgery include infection, stiffness, skin numbness near the incision, persistent swelling, and persistent pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Difference of Using Custom Foot Orthotics


References

Walt, J., & Massey, P. (2025). Peroneal Tendon Syndromes. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/31335074

Saxena, A., & Bareither, D. (2001). Magnetic resonance and cadaveric findings of the “watershed band” of the Achilles tendon. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 40(3), 132–136. https://doi.org/10.1016/s1067-2516(01)80078-8

Dombek, M. F., Orsini, R., Mendicino, R. W., & Saltrick, K. (2001). Peroneus brevis tendon tears. Clinics in podiatric medicine and surgery, 18(3), 409–427.

Castilho, R. S., Magalhães, J. M. B., Veríssimo, B. P. M., Perisano, C., Greco, T., & Zambelli, R. (2024). Minimally Invasive Peroneal Tenodesis Assisted by Peroneal Tendoscopy: Technique and Preliminary Results. Medicina (Kaunas, Lithuania), 60(1), 104. https://doi.org/10.3390/medicina60010104

Push-Pull Workout: A Comprehensive Guide

Can a push-pull workout routine be an option for individuals who want focused training on specific muscle groups and balanced muscle development throughout the body?

Push-Pull Strength Training

A “push-pull” workout is a training style in which you split your exercise routine into separate days dedicated to “push” exercises (targeting muscles like the chest, shoulders, and triceps) and “pull” exercises (targeting muscles like the back and biceps). This allows focused training on each muscle group by isolating their primary movement patterns—pushing away from the body or pulling towards it. The workout often accompanies a separate leg day to complete the full-body workout. This routine comes from bodybuilding. Bodybuilders use this method to maximize their workouts and rest periods. By splitting their workouts into push exercises one day and pull exercises another, they can work out more often without overtraining. (Castanheira R. P. M. et al., 2017)

Upper Body Push Exercises

These exercises involve all the movements that push the weights away from your body. These exercises typically focus on the quads, outer thighs, chest, shoulders, and triceps. (Collins P. 2009)

Pushups

  • Push-ups are a versatile bodyweight exercise that engages multiple muscle groups, including the chest, shoulders, triceps, and core.

Chest Presses

  • Chest presses are exercises that target the pectoral muscles (chest muscles).
  • They can be performed with various equipment and techniques, providing a comprehensive workout for the chest.

Chest Flies

  • Chest flies are a weightlifting exercise that targets the pectoral muscles (chest muscles).
  • They are performed by lying on a bench and extending the arms outward with weights in each hand.
  • The weights are then lowered in an arc motion until they are slightly below chest level before being raised back to the starting position.

Overhead Presses

  • An overhead press is a weight-training exercise that involves pushing a weight above your head.
  • Also known as a shoulder, military, or strict press.

Lateral Raises

  • Lateral raises are an isolation exercise that targets the lateral deltoid muscle on the shoulder’s side.
  • They raise the arms laterally (out to the sides) while slightly bending at the elbows.

Bent Arm Lateral Raises

  • A bent-over lateral raise is a weightlifting exercise that strengthens the rear deltoids, the muscles on the back of the shoulders.
  • It also works other upper and lower body muscles, including the trapezius, rhomboids, triceps, hamstrings, and lower back.

Front Raises

  • Front raises are a weight training exercise that targets the shoulder muscles.
  • They can also help build strength and stability in the upper body.

Dips

  • Dips are an upper-body exercise that uses your body weight to strengthen your triceps and chest.

Triceps Extensions

  • Triceps extensions are resistance exercises that target the triceps muscles in the back of the upper arm.
  • They involve extending the arms at the elbows while keeping the shoulders stationary.

Skull Crushers

  • Skull crushers are a weightlifting exercise that targets the triceps muscles in the upper arms.
  • They are performed by lying on a bench or floor, holding a weight (such as a dumbbell or barbell) overhead, and then lowering it towards the forehead while keeping the elbows slightly bent.
  • This exercise helps to strengthen and build muscle mass in the triceps.

Upper Body Pull Exercises

Pull exercises are movements where you are pulling the weight toward your body. These exercises primarily use the biceps, hamstrings, glutes, and back muscles. A routine set up in which you do a push routine one day and a pull routine the next without working the same muscles two days in a row.

Barbell Rows

  • Often referred to as a “bent-over row” due to the hinged position of your body during the movement.
  • A barbell row is a weightlifting exercise in which you bend over at the hips, grasp a barbell with an overhand grip, and pull the weight toward your stomach.
  • This exercise primarily targets the upper back muscles, including the latissimus dorsi, while also engaging the core and posterior chain muscles.

One Arm Rows

  • A variation of the bent-over row, a one-arm row, also known as a single-arm dumbbell row, is an upper-body exercise that targets the back muscles using a dumbbell and a bench.

Double arm rows

  • A “double arm row” is a rowing exercise in which you simultaneously pull a weight toward your body using both arms, typically with a barbell or dumbbell.
  • This exercise engages your upper back muscles, including the latissimus dorsi, trapezius, and rhomboids.
  • To effectively target the back muscles, you maintain a bent-over position. Essentially, it’s the opposite movement of a chest press, but you use both arms simultaneously.

Barbell High Rows

  • A barbell high row, also known as a wide row, is an exercise that uses a barbell to work the upper and mid back muscles.

Dumbell Pullovers

  • Dumbbell pullovers are a weightlifting exercise that targets the chest, back, and shoulder muscles.

Seated Rows with Resistance Bands

  • A “seated row with bands” is an exercise where you sit on the ground, loop a resistance band around your feet, and then pull the handles towards your chest, mimicking a rowing motion.
  • By squeezing the shoulder blades together, this motion primarily targets the upper back muscles, including the latissimus dorsi and rhomboids.
  • You are essentially performing a seated row movement using the tension of a resistance band instead of weights.

Lat Pulls with Resistance Band

  • Lat pulls with a resistance band are a back exercise that strengthens the latissimus dorsi muscles and can improve posture.

Back extensions

  • Back extensions are an exercise that strengthens and isolates the lower back muscles, also known as the erector spinae.

Seated Alternating Rows

  • A seated alternating row is an exercise that targets the upper back, biceps, and lats.
  • It can be performed using a resistance machine or with a band.

Renegade Rows

  • A renegade row is a full-body exercise that combines a plank with a dumbbell row.
  • It’s an advanced exercise that targets the upper body, back, shoulders, and core.

Biceps Curls

  • A bicep curl involves bending the arm at the elbow towards the body, strengthening the biceps, the large muscles in the front of the upper arm.

Home Equipment

Resistance bands and a quality pair of adjustable dumbbells are recommended for home training. These don’t take up much space and can be used for most upper-body exercises. To set up a more dedicated space for workouts, add a weight bench or a full home gym to increase your push-pull training options.

Benefits

Push-pull workouts are great for anybody, whether you’re a bodybuilder or just someone lifting weights to be strong and fit. This routine is usually spread out over three days of training, allowing for shorter workouts. These can help you stay committed despite a busy schedule and are easier than longer, total-body workouts. These exercises can also be done with a cable pulley system or resistance bands.

  1. Day 1 might be a push upper body workout.
  2. Day 2 might be a lower-body workout.
  3. Day 3 might be the pull upper body workout.

First, push-pull workouts allow you to work your muscles without overstressing them. (Castanheira R. P. M. et al., 2017) Second, although they are more frequent, push-pull workouts are shorter, so more can be done because your other muscles are resting. Third, push-pull routines are more interesting and contain more variety, as they can be done in various ways.

Alternating Workouts

Trainers recommend changing workouts every 6-12 weeks to avoid hitting a plateau, which can delay weight loss (American Council on Exercise, 2001). For example, you could do a push-pull routine for a few weeks and then switch to a different training method, pyramid training. Then, return to total body workouts, which you can do up to 3 non-consecutive days a week. Circuit training may be an option because the quick workouts allow you to get your cardio in simultaneously. (Haltom R. W. et al., 1999) With so many different training methods, there’s no need to do the same workouts repeatedly.

Injury Medical Chiropractic and Functional Medicine Clinic

For those who are easily bored with weight training and prefer a variety of exercises, this can be a refreshing way to stay focused and avoid burnout. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Transform Your Body


References

Castanheira, R. P. M., Ferreira-Junior, J. B., Celes, R. S., Rocha-Junior, V. A., Cadore, E. L., Izquierdo, M., & Bottaro, M. (2017). Effects of Synergist vs. NonSynergist Split Resistance Training Routines on Acute Neuromuscular Performance in Resistance-Trained Men. Journal of strength and conditioning research, 31(12), 3482–3488. https://doi.org/10.1519/JSC.0000000000001762

Collins, P. (2009). Functional Fitness. Germany: Meyer & Meyer Sport, Limited.

American Council on Exercise. (2001). Weight Loss Plateaus and Pitfalls. ACE. https://contentcdn.eacefitness.com/assets/education-resources/lifestyle/fitfacts/pdfs/fitfacts/itemid_69.pdf

Haltom, R. W., Kraemer, R. R., Sloan, R. A., Hebert, E. P., Frank, K., & Tryniecki, J. L. (1999). Circuit weight training and its effects on excess postexercise oxygen consumption. Medicine and science in sports and exercise, 31(11), 1613–1618. https://doi.org/10.1097/00005768-199911000-00018

The Importance of Sleep for Athletes: Maximizing Performance

Athletic individuals must train regularly, eat healthy, and rest properly to recover and perform their best. Is sleep different for athletes?

Athletes and Sleep

Physical activity is an important component of a healthy lifestyle. Regular exercise increases longevity and can also reduce the risk of anxiety and depression and improve sleep (Centers for Disease Control and Prevention, 2024). When one area is lacking for athletes, overall performance can suffer. Evidence shows that more or extended sleep can benefit athletes and their recovery and performance. (Bird, Stephen P. 2013) Recommendations for athletes range between seven and nine hours nightly, and elite athletes are encouraged to get at least nine hours of sleep nightly and to treat sleep as much as athletic training and diet.

Sleep is essential for overall health and well-being for both athletes and non-athletes. Everyone needs sleep to feel restored and function their best daily. (Richard J. Schwab, 2024) Other physical benefits include:

Cardiovascular Recovery

This allows the heart to rest and cells and tissue to be repaired. (MedlinePlus, 2017) This can help the body recover after physical exertion. As an individual progresses through the stages of sleep, the changes in heart rate and breathing throughout the night promote cardiovascular health (National Heart, Lung, and Blood Institute, 2011)

Illness Prevention 

The proper amount of sleep helps the body recover from illness. During sleep, the body produces cytokines/hormones that help the immune system fight off infections. These therapeutic effects are important for an athlete’s recovery and performance.

Lack of Sleep Affects Performance

Poor quality and quantity of sleep can lead to several negative effects. Sleep deprivation reduces the ability to react quickly and think clearly. A lack of sleep also increases irritability and risk for anxiety and depression. Sleep-deprived individuals are more likely to make poor decisions and take unnecessary risks. From a physical standpoint, a lack of sleep increases the risk for medical concerns, including type 2 diabetes, high blood pressure, kidney disease, and stroke. When athletes do not receive adequate sleep, it can:

Inhibit Ability

  • In a study of sleep-deprived male team athletes, average and total sprint times decreased. (Skein, M. et al., 2011)

Decrease Accuracy

  • In a study, male and female sleep-deprived tennis players had decreased serve accuracy by up to 53% compared to performance after normal sleep. (Reyner L. A. & Horne J. A. 2013)

Cause Quicker Exhaustion

  • A study of male runners and volleyball players found that both athletes exhausted faster after sleep deprivation. (Azboy O. & Kaygisiz Z. 2009)

Decrease Reaction Time

Difficulty Learning and Decision Making

  • A lack of sleep negatively impacts cognitive skills and functions.
  • Athletes can become distracted, and decisions like passing the ball or going for the smash can be difficult or made too late.

Increases Risk of Injury

  • Research on middle—and high-school athletes showed that chronic lack of sleep was associated with increased rates of injury. (Milewski M. D. et al., 2014)

Increases The Risk of Illness or Immunosuppression

Athletic Sleep Hygiene

Common components to sleep well include:

Avoid alcohol and Caffeine

  • Before bedtime, these can interrupt sleep or lead to more disturbed sleep.

Have a Wind-Down Routine

  • Activities such as reading, bathing, or meditating can help the body relax and get ready for sleep.

Reduce Stressors

  • Not only do mental stressors affect sleep quality, but they also impact performance overall.

Create an Optimal Sleep Environment

  • A sleeping space should be dark and cool with little to no noise.
  • The environment should be used only for sleep and sex.

No Electronics Before Bed

  • This includes TVs, cell phones, and computers.
  • The blue light that these devices emit can affect circadian rhythm.

Don’t Stay Awake In Bed

  • If you can’t fall asleep after 20 minutes of trying, get out of bed.
  • Do a quiet activity in another space until you feel sleepy.

Avoid Overtraining

  • Keep a consistent training schedule so as not to overexert yourself.

Quick Naps

  • Keep naps brief. Naps should be longer than an hour and not after 3 p.m.

Injury Medical Chiropractic and Functional Medicine Clinic

The right bed and mattress contribute to overall health and can improve one’s quality of life. Doctor Alexander Jimenez, DC, at Injury Medical Chiropractic and Functional Medicine Clinic, says a healthy mattress can improve sleep, reduce pain, increase energy levels, and elevate mood. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Lumbar Spine Injuries In Athletes


References

Centers for Disease Control and Prevention. (2024). Benefits of Physical Activity. Retrieved from https://www.cdc.gov/physical-activity-basics/benefits/?CDC_AAref_Val=https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm

Bird, Stephen P. PhD. (2013). Sleep, Recovery, and Athletic Performance: A Brief Review and Recommendations. Strength and Conditioning Journal, 35(5), 43-47. https://doi.org/DOI: 10.1519/SSC.0b013e3182a62e2f

Schwab, R. J. (2024). Overview of Sleep. Merck Manual Consumer Version. https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/sleep-disorders/overview-of-sleep

National Library of Medicine. MedlinePlus. (2017). Healthy Sleep Also called: Sleep Hygeine. Retrieved from https://medlineplus.gov/healthysleep.html

National Heart, Lung, and Blood Institute. (2011). Your guide to healthy sleep. Retrieved from https://www.nhlbi.nih.gov/resources/your-guide-healthy-sleep

Skein, M., Duffield, R., Edge, J., Short, M. J., & Mündel, T. (2011). Intermittent-sprint performance and muscle glycogen after 30 h of sleep deprivation. Medicine and science in sports and exercise, 43(7), 1301–1311. https://doi.org/10.1249/MSS.0b013e31820abc5a

Reyner, L. A., & Horne, J. A. (2013). Sleep restriction and serving accuracy in performance tennis players, and effects of caffeine. Physiology & behavior, 120, 93–96. https://doi.org/10.1016/j.physbeh.2013.07.002

Azboy, O., & Kaygisiz, Z. (2009). Effects of sleep deprivation on cardiorespiratory functions of the runners and volleyball players during rest and exercise. Acta physiologica Hungarica, 96(1), 29–36. https://doi.org/10.1556/APhysiol.96.2009.1.3

Taheri, M., & Arabameri, E. (2012). The effect of sleep deprivation on choice reaction time and anaerobic power of college student athletes. Asian journal of sports medicine, 3(1), 15–20. https://doi.org/10.5812/asjsm.34719

Milewski, M. D., Skaggs, D. L., Bishop, G. A., Pace, J. L., Ibrahim, D. A., Wren, T. A., & Barzdukas, A. (2014). Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. Journal of pediatric orthopedics, 34(2), 129–133. https://doi.org/10.1097/BPO.0000000000000151

Prather, A. A., Janicki-Deverts, D., Hall, M. H., & Cohen, S. (2015). Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep, 38(9), 1353–1359. https://doi.org/10.5665/sleep.4968