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Category: Work Injury

ChiroMedBlogWork Injury
By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Physio, Work Injury , , , , , , , , , , , , , , , , , , ,

Pulled Muscle: Understanding the Healing Process

What are the recommendations for a pulled muscle injury to fully recover?

Pulled Muscle Recovery Time

A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015)  Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.

Timeline

The timeline for recovering from a pulled muscle depends on the injury’s severity.

Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)

Grade 1 (mild)

  • Heals in a few days.
  • A microscopic tear or stretch in the muscle fiber.
  • It might feel sore, but you can still use the muscle.

Grade 2 (moderate)

  • Heals in four to six weeks.
  • A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.

Grade 3 (severe)

  • Heals in several months
  • This type of muscle strain causes a complete tear, also known as a rupture.
  • It results in intense pain, significant swelling, and inability to use the muscle.
  • Surgery may be required in some cases.
  • Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.

Body Parts More Susceptible To Injury

The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)

  • Neck – levator scapulae and trapezius
  • Shoulders – rotator cuff muscles
  • Lower back – erector spinae
  • Groin – adductors
  • Front of the thigh – quadriceps
  • Behind the thigh – hamstrings
  • Calves – gastrocnemius and soleus

Healing Stages and Factors

Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).

Inflammatory Stage (zero to three days)

  • When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
  • Rest is important during this stage to prevent the injury from getting worse.

Repair Stage (three to 21 days)

  • Damaged muscle fibers are repaired and regrow during this stage.
  • Collagen fills in any tears to rebuild damaged muscle tissue.
  • Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
  • Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.

Remodeling Stage (three weeks to one year)

  • Repaired tissue gets stronger and adapts to regular movement.
  • Scar tissue may form.
  • Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.

Faster Healing

To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016)

Rest

  • Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
  • Prolonged rest can slow healing, so maintain a balance between rest and exercise.

Ice

  • Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
  • Ice helps control inflammation by limiting blood flow to the injured area.

Compression

  • Use compression stockings or wrap the injured part in bandages to help reduce swelling.
  • Ensure the binding is not too tight so circulation is not cut off.

Elevation

  • Raise the injured area above heart level throughout the day.
  • This helps reduce swelling by allowing fluids to drain away from the injury site.

Heat

  • After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.

Eat Healthy

  • Get enough protein for muscle repair.

Maintain Hydration

  • Drink plenty of water to help with circulation and muscle lubrication.

Massage and Physical Therapy

  • These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.

Over-the-counter Medications

  • If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
  • Only use as directed.

These steps can help promote faster healing and expedite returning to normal daily activities.

When to Resume Normal Activity

Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)

  • Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
  • Slowly resume normal activities, avoiding overexerting the injured area.
  • Gradually increase activity levels and stop if there is any pain.
  • Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.

Contact a Healthcare Provider

While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)

  • Pain persists or worsens after seven to 10 days.
  • This can indicate a more serious injury, such as a severe torn muscle.
  • Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
  • It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
  • There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
  • There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.

A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.

Injury Medical Chiropractic & Functional Medicine Clinic

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, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can 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.

Say Goodbye to Pain with Chiropractic Care

References

Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7

Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp

Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463

Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012

Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7

Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156

Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Work Injury , , , , , , , , , , , , , , , , , , ,

Scaphoid Fracture Causes and Recovery Insights

Individuals who have fractured their scaphoid bone may experience pain and swelling in the wrist just below the thumb. Can immobilization with a cast and physical therapy help?

human hand and wrist pain

Scaphoid Fracture

A scaphoid fracture is a break in one of the wrist’s small or carpal bones. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms typically include swelling and pain in the wrist just below the base of the thumb. These fractures can be difficult to diagnose since they don’t always appear on an X-ray. If the X-ray is negative and the healthcare provider suspects a scaphoid fracture, an MRI may be necessary. Surgery may be required in more severe cases or when the injury is not healing correctly. (American Academy of Orthopaedic Surgeons, 2023)

A Break In The – Navicular Bone

The scaphoid is one of eight carpal bones in the wrist. It is located just below the thumb’s base and is shaped like a kidney bean. This bone can be identified by holding a thumbs-up position and feeling for the hollow between the two tendons below your thumb. The scaphoid is located at the base of the hollow. A break in the scaphoid bone most commonly occurs in the middle of the bone but can also happen at either end. A scaphoid fracture can be displaced or non-displaced (American Academy of Orthopaedic Surgeons, 2023)

Displaced Fracture

  • It is when the bone fragments have moved out of alignment.

Non-displaced Fracture

  • It is when the fragments are still in their normal location in the hand.

The scaphoid’s blood supply comes from a small vessel that enters the most distant part of the bone and flows back through the bone. Because of this one small blood supply, a fracture in the center can stop the circulation to the proximal portion of the bone. Because of this, scaphoid fractures need immediate diagnosis and treatment.

Symptoms

Pain or deep aching on the thumb-side of the wrist, typically after a fall on an outstretched arm, could be a scaphoid fracture. Other symptoms experienced include: (American Academy of Orthopaedic Surgeons, 2023)

  • Tenderness at the base of the hollow area.
  • Pain at the base of the hollow area.
  • Swelling in the wrist
  • Difficulty gripping objects

Pain can become worse from: (American Academy of Orthopaedic Surgeons, 2023)

  • Grasping
  • Pulling
  • Pushing
  • Pinching

Diagnosis

A healthcare provider will evaluate the hand for tenderness and pain in the hollow and/or the bone. If a break is suspected, they will order an X-ray. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) Many patients are diagnosed with a wrist sprain when they have a fracture. Diagnosis can be difficult because the fracture often doesn’t appear on X-rays until weeks after the healing process starts. Physicians commonly treat a wrist injury as a scaphoid fracture initially and then repeat X-rays within two weeks. (American Academy of Orthopaedic Surgeons, 2023) If the injury doesn’t show on an X-ray, the provider may order an MRI, as these fractures can be easier to see on an MRI. An MRI can help ensure appropriate treatment immediately. (Wong S. B. S., & Peh W. C. G. 2019)

Treatment

If a wrist fracture is diagnosed, the wrist will be immobilized in a cast. However, a healthcare provider may also put the wrist in a cast if the X-ray is negative but they suspect a fracture. This will stabilize the injury until an MRI can be performed. With immobilization and follow-up treatment, scaphoid fractures often heal without surgery. Repeat X-rays are taken over several weeks or months so the provider can make sure the injury is healing correctly. If it is not healing correctly, surgery may be recommended. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) If the fracture is displaced, healing correctly may be a challenge. In this case, a physician may recommend initial surgery to reposition the bones. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) This type of surgery involves pinning the bone in place with screws.

Healing Time

Recovery

With the wrist in a cast, individuals will be instructed on activities to avoid placing even a small amount of strain (American Academy of Orthopaedic Surgeons, 2023)

  • Lifting
  • Pushing
  • Pulling objects that weigh more than one pound.
  • Sports activities
  • Throwing
  • Climbing
  • Using tools or machinery that vibrate.

Rehabilitation is an important part of healing because immobilization takes a long time. Wrist range-of-motion exercises can be started, followed by strengthening exercises for the wrist flexors and extensors. Supination, pronation, and grip exercises are also part of physical therapy.

Complications

Scaphoid fractures can lead to serious complications, especially when not properly treated. These include: (American Academy of Orthopaedic Surgeons, 2023) (Almigdad A. et al., 2024)

Nonunion

  • This describes a fracture that fails to heal.

Carpal Collapse

  • This is a form of degenerative arthritis.

Osteoarthritis

  • This condition causes degeneration of the cartilage in the joint.

Avascular Necrosis

  • This is when the blood supply to the bone is reduced or cut off, causing the bone to die.

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 mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Skateboarding Injury Treatment

References

American Academy of Orthopaedic Surgeons. (2023). Scaphoid fracture of the wrist. https://orthoinfo.aaos.org/en/diseases–conditions/scaphoid-fracture-of-the-wrist

Clementson, M., Björkman, A., & Thomsen, N. O. B. (2020). Acute scaphoid fractures: guidelines for diagnosis and treatment. EFORT open reviews, 5(2), 96–103. https://doi.org/10.1302/2058-5241.5.190025

Wong, S. B. S., & Peh, W. C. G. (2019). The role of magnetic resonance imaging in the evaluation of scaphoid fractures. Journal of Medical Radiation Sciences, 66(1), 3–4. https://doi.org/10.1002/jmrs.316

Almigdad, A., Al-Zoubi, A., Mustafa, A., Al-Qasaimeh, M., Azzam, E., Mestarihi, S., Khair, Y., & Almanasier, G. (2024). A review of scaphoid fracture, treatment outcomes, and consequences. International orthopaedics, 48(2), 529–536. https://doi.org/10.1007/s00264-023-06014-2

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Work Injury , , , , , , , , , , , , , , , , ,

Triceps Tendonitis: A Guide to Prevention and Treatment

Triceps tendonitis can be frustrating, especially when you need to rest from normal activities. Can knowing the causes, symptoms, and diagnosis help individuals understand the treatment and prevention of the condition?

Triceps Tendonitis

Tendons are connective tissue that attach muscles to bones, enabling the joints to move. Triceps tendonitis is inflammation of the tendon at the back of the elbow. It is most often caused by overuse of the triceps muscles. The condition can cause pain, swelling, and loss of function. It’s common in jobs that require regular hammering, shoveling, and overhead reaching, as well as in weightlifters, gymnasts, and boxers.

Causes

The triceps muscle runs along the back of the upper arm and is attached to the point of the elbow by a tendon. This muscle straightens the elbow. Tendonitis develops from repeatedly straightening the elbow against resistance. This causes tiny tears in the tissue, which leads to inflammation. Triceps tendonitis commonly occurs from repetitive manual labor tasks or sports activities like throwing sports, gymnastics, or boxing. Exercises that target the triceps muscle can cause tendonitis to develop, including kickbacks, dips, push-ups, and bench presses. For this reason, triceps tendonitis is also known as weightlifter’s elbow. (Orthopedic & Spine Center, N.D.)

Symptoms

Inflammation leads to a series of chemical reactions in the area of the injury. There are five main symptoms of inflammation:

  • Redness
  • Warmth
  • Swelling
  • Pain
  • Loss of function

With triceps tendonitis, the pain and stiffness are felt at the back of the elbow. Weakness may also present when using the affected arm. Tendonitis usually causes more pain with movement than when resting. Pain can occur when straightening the elbow, which puts tension on the triceps, or bending the elbow, which stretches the tendon.

Diagnosis

A healthcare provider will ask questions and perform a physical exam to diagnose tendonitis. (Harvard Health Publishing, 2014) A healthcare provider will ask you to describe the pain and the activities that make it better or worse. The elbow will be assessed for movement issues, swelling, or deformities that could indicate a worse injury, like a tendon tear. A healthcare provider will order X-rays or other imaging, such as MRI, to assess for a bone fracture or more extensive damage to the tendon.

Treatment

Several types of treatments include self-care, physical therapy, and medications.

Self Care

Triceps tendonitis can be treated at home if symptoms are addressed early. These include:

Rest

  • Rest the triceps tendon by avoiding activities that cause pain for a few days.

Ice

  • Apply ice to the triceps tendon for 15 to 20 minutes, two to three times daily.
  • Massage the area with an ice cube for several minutes.

Range of Motion Exercises

  • Decrease stiffness in the elbow with gentle range of motion exercises.
  • Slowly bend and straighten the elbow in a pain-free range, 10 times.
  • Repeat several times per day.

Physical Therapy

Physical therapists use various therapies and tools when treating tendonitis, including (Prall J. & Ross M. 2019)

PT Modalities

  • Physical therapy modalities are used to decrease pain, inflammation, and stiffness.
  • Examples include ultrasound, electrical stimulation, and light therapy.

Manual Therapy

  • Manual techniques for tendonitis include soft tissue massage, friction massage, stretching, and joint mobilization.

Exercise

  • Stretching and strengthening exercises that target the triceps muscle and any other muscle weakness that might have contributed to the condition.

Activity Modification

  • A therapist will look at the activities that led to the tendonitis and ensure you use the correct form and proper body mechanics.
  • Sometimes, a physical therapist can make on-site changes in the work environment to help prevent further injury.

Medications

Medications that are used to treat the condition (Aurora Health Care, 2025)

NSAIDs

  • Nonsteroidal anti-inflammatory medications are often used to treat tendonitis.
  • Many are available over-the-counter, including Aleve, Bayer, and Advil.
  • These medications can also be prescribed in higher doses by a healthcare provider.

Pain-Relievers

  • Additional over-the-counter medications such as Tylenol can help decrease pain.

Oral Steroids

  • These medications might be prescribed for short-term use to decrease inflammation if over-the-counter medications are ineffective in treating symptoms.
  • Long-term use of oral steroids can cause more damage to the tendons. (Spoendlin J., Meier C., Jick S. S., & Meier C. R. 2015)

Corticosteroid Injections

  • Tendonitis is frequently treated with an injection of steroid medication to decrease inflammation.
  • However, having multiple injections in the same area can eventually cause tendons to weaken more. (NYU Langone Health, 2024)

Platelet-Rich Plasma

  • PRP is made by taking a small amount of blood and separating the platelets or cells that release growth factors to promote healing.
  • The liquid is then injected into the tendon.
  • PRP is controversial; some studies support its use, while others do not.
  • While PRP may show some promise, insurance may not cover PRP treatments because of the ambiguity in the clinical data.

Injury Medical Chiropractic and Functional Medicine Clinic

Prevention is key. Warming up before a workout, stretching, and using the proper form can help prevent triceps tendonitis. Temporarily halting activities to address symptoms can prevent more serious injury. 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.

From Inflammation to Healing

References

Orthopedic & Spine Center. (N.D.). Triceps Tendonitis or Weightlifter’s Elbow. https://www.osc-ortho.com/resources/elbow-pain/triceps-tendonitis-or-weightlifters-elbow/

Harvard Health Publishing. (2014). Tendonitis. https://www.health.harvard.edu/diseases-and-conditions/tendonitis

Prall, J., & Ross, M. (2019). The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. Journal of Exercise Rehabilitation, 15(2), 193–199. https://doi.org/10.12965/jer.1836636.318

Aurora Health Care. (2025). Tendonitis symptoms & treatment. https://www.aurorahealthcare.org/services/orthopedics/conditions/tendonitis

Spoendlin, J., Meier, C., Jick, S. S., & Meier, C. R. (2015). Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study. Annals of Medicine, 47(6), 492–498. https://doi.org/10.3109/07853890.2015.1074272

NYU Langone Health. (2024). Therapeutic injections for bursitis & tendinitis in adults. https://nyulangone.org/conditions/bursitis-tendinitis/treatments/therapeutic-injections-for-bursitis-tendinitis

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Work Injury , , , , , , , , , , , , , , , ,

A Closer Look at the Different Stages of Frozen Shoulder

For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain?

Frozen Shoulder Stages

A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing.

Stage 1

Pre-Freezing – 1 month to 3 months

Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017)

Root Cause

A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren’t known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025)

Stage 2

Freezing – 10 weeks to 8 months

The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024)

Stage 3

Frozen – 4 months to 12 months

The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult.

Stage 4

Thawing – 5 months to 2 years

In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint’s mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable.

Treatment

Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019)

Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017)

Prognosis

The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints.

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.

Motion Key To Healing

References

Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. https://doi.org/10.1067/j.cpradiol.2024.03.005

Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. https://doi.org/10.11622/smedj.2017107

Johns Hopkins Medicine. (2025). Frozen shoulder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder

UpToDate. (2024). Patient education: Frozen shoulder (beyond the basics). https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. https://doi.org/10.5435/JAAOS-D-17-00606

Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. https://doi.org/10.1177/1758573216676786

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Therapy, Work Injury , , , , , , , , , , , , , , , , ,

How Outcome Measurement Tests Can Guide Treatment

Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?

Outcome Measurement Tests

Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.

Function and Purpose

Outcome measurement tests serve various purposes. These include: (American Physical Therapy Association, N.D.)

  • To assist in goal-setting
  • Provide motivation
  • To guide treatment
  • To give a prognosis for the specific condition
  • To justify the treatment

The physical therapist may use other functional outcome measurements to help assess physical therapy progress.

  • They may measure your strength and range of motion.
  • Balance and posture may be evaluated.

Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.

Common Outcome Measurement Tests Used

Common functional outcome measurement tools that a physical therapist may use include:

  • The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
  • The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
  • The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
  • The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
  • The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues. 
  • The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability. 
  • The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.

Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.

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.

Understanding The Effects of Personal Injury

References

American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. https://www.apta.org/your-practice/outcomes-measurement

Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf

Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. https://doi.org/10.1038/s41598-022-21547-z

Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. https://doi.org/10.1177/2150131916659282

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Work Injury , , , , , , , , , , , , , , , , , , ,

Wrist Sprain: Diagnosis and Treatment Options

Can knowing about wrist sprains—their types, symptoms, causes, and diagnoses—help develop an effective treatment program?

Wrist Sprain

Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall from work overuse, house tasks, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include:

  • Pain
  • Swelling
  • Bruising
  • Decreased range of motion
  • Weakness
  • Tingling

The injury affects the ligaments and soft tissue structures connecting bone to bone. Mild wrist sprains typically heal within a few weeks; most heal without complications in six to 12 weeks. (National Health Service, 2020) However, severe injuries can require surgery, physical therapy, and months to recover fully.

Grades and Types

The three grades of sprains are graded by the severity of the injury (American Academy of Orthopaedic Surgeons, 2024)

Grade 1

  • Ligaments are stretched; this is considered a mild sprain.
  • The injury may heal in one to three weeks with standard care. (Mass General Brigham, 2025)

Grade 2

  • Ligaments are partially torn; this is considered a moderate sprain.
  • It may need a brace; healing can take three to six weeks. (Mass General Brigham, 2025)

Grade 3

  • Ligaments are torn completely or have pulled away from the bone.
  • Sometimes, a piece of bone comes off with it, a condition called an avulsion fracture.
  • This is considered a severe sprain. It can take months to heal completely. (Mass General Brigham, 2025)

The wrist is made up of three joints (American Society for Surgery of the Hand, 2017)

Distal radioulnar

  • This joint is between the two forearm bones.
  • The radius on the thumb side.
  • The ulna on the pinky side.

Radiocarpal

  • This joint is between the radius and three small bones in the base of the hand.
  • The scaphoid
  • The triquetrum
  • The lunate

Ulnocarpal

  • This joint is between the ulna and the articular disc and cushions it from the carpal bones, the lunate, and the triquetrum.

Wrist sprains can affect any of these joints but more commonly affect the ligament between the scaphoid and lunate bone or the triangular fibrocartilage complex/TFCC on the pinky side of the wrist.

Symptoms

The primary symptom of a wrist sprain is pain, especially when moving or touching the injured area. Other symptoms can include: (National Library of Medicine, 2021) (American Academy of Orthopaedic Surgeons, 2024)

  • Decreased range of motion
  • Swelling
  • Bruising
  • Feeling instability in the wrist 
  • Weakness
  • Numbness/tingling
  • Popping sensation
  • Warm skin

Causes

The common cause of wrist sprain is falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2024) Other common causes include:

  • Repetitive overuse work injuries.
  • Housework and tasks.
  • Sports include skateboarding, gymnastics, basketball, snowboarding, hockey, and contact sports.

Diagnosis

A healthcare provider will diagnose a wrist sprain based on symptoms and injury causes. X-rays are the first imaging to rule out fractures. Other tests can include:

  • Magnetic resonance imaging – MRI
  • Computed tomography – CT scan
  • Arthrogram -X-rays with contrast dye

Treatment

Nonsteroidal anti-inflammatory drugs, such as Aleve, Advil, Motrin, and aspirin, can treat pain and inflammation. The severity of the wrist sprain determines whether additional treatment is needed. Sprains should initially be treated with the RICE protocol (American Academy of Orthopaedic Surgeons, 2024)

Rest

  • Minimize using the injured wrist for at least two days.
  • Wear a splint for support.
  • Avoid sudden movements.
  • Avoid placing too much pressure on the wrist.

Ice

  • Cold packs are recommended several times daily for 20 minutes to decrease pain and swelling.

Compression

  • Wrap the wrist with an elastic bandage or Kinesio tape to help reduce swelling.

Elevation

  • To decrease swelling, use pillows to elevate the wrist as much as possible above the level of your heart.
  1. Grade 1 sprains usually heal with basic care within a week or two.
  2. Grade 2 sprains often require wearing a brace for an extended period while the ligament heals, which can take up to six weeks. (American Society for Surgery of the Hand, 2018)
  3. The removable brace or splint should be worn when using the arm.
  4. It can be taken off at rest at night and when bathing. (National Health Service, 2020)
  5. Individuals may need the brace for a week or more.

A healthcare provider may also recommend stretching exercises to overcome stiffness and regain mobility. (American Academy of Orthopaedic Surgeons, 2024) Physical therapy, occupational therapy, or treatment by a certified hand therapist can also reduce pain and improve range of motion and strength.

Treatment for grade 3 sprains often requires surgery. Grade 3 sprains, including avulsion fractures, often require a six-week cast for bones to heal. In some cases, the bones might also need a screw or temporary wires to hold them in the proper position. (Vannabouathong, C. et al., 2018) Severe wrist sprains may also require surgery to repair the injured ligament. If the original ligament cannot be repaired, a piece of the tendon can be used to reconstruct it. (American Society for Surgery of the Hand, 2020)

Healing Time

Mild to moderate sprains usually recover within a few weeks without long-term complications. (American Society for Surgery of the Hand, 2018) The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight to 12 weeks but can take six to 12 months for function to return to normal. (American Academy of Orthopaedic Surgeons, 2024)

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 Path to Healing Personal Injury

References

National Health Service. (2020). Advice after spraining your wrist. https://www.ruh.nhs.uk/patients/patient_information/ORT_057_Advice_after_a_wrist_sprain.pdf

American Academy of Orthopaedic Surgeons. (2024). Wrist sprains. https://orthoinfo.aaos.org/en/diseases–conditions/wrist-sprains

Mass General Brigham. (2025). Wrist sprains. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hand-arm/wrist-sprain

American Society for Surgery of the Hand. (2017). Anatomy 101: Wrist joints. https://www.assh.org/handcare/blog/anatomy-101-wrist-joints

National Library of Medicine. (2021). Wrist injuries and disorders. Retrieved from https://medlineplus.gov/wristinjuriesanddisorders.html

American Society for Surgery of the Hand. (2018). Sprained wrist. https://www.assh.org/handcare/condition/sprained-wrist

Vannabouathong, C., Ayeni, O. R., & Bhandari, M. (2018). A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clinical medicine insights. Arthritis and musculoskeletal disorders, 11, 1179544118809050. https://doi.org/10.1177/1179544118809050

American Society for Surgery of the Hand. (2020). Scapholunate torn ligament. https://www.assh.org/handcare/condition/scapholunate-torn-ligament

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Sleep Hygiene, Work Injury , , , , , , , , , , , , , , , , , ,

The Dangers of Sleep Debt: Health Consequences

Individuals who don’t get enough sleep at night can feel it in many ways. Can sleep deprivation or other sleep disorders contribute to an accumulated sleep debt?

Sleep Debt

Sleep debt is the difference between the amount of sleep an individual needs and the amount they get. It can accumulate over time and can negatively impact physical and mental health.

What Is It?

Regardless of the cause, sleep debt, also called a sleep deficit, is the accumulated amount of sleep loss from insufficient sleep. (Harvard Health Publishing, 2019) For example, if the body needs eight hours of sleep a night but only gets six, it has accumulated two hours of sleep debt for that particular night. This can occur due to sleep restriction, in which too few hours are spent sleeping, which can have significant consequences, especially if the debt builds.

The Effects

Sleep deprivation is linked to various mental and physical health problems, including:

  • Poor concentration or short-term memory
  • Depression and anxiety
  • High blood pressure
  • Heart disease
  • Diabetes
  • Kidney disease

Sleep deprivation can also contribute to other long-term health consequences. Individuals can have hallucinations and even a potentially increased risk of death. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006) Symptoms of discomfort and pain are also worsened by poor sleep.

Other Causes

Other possible causes of poor sleep quality can include individuals who have a sleep disorder such as insomnia, sleep apnea, or circadian rhythm disorders, which could lead to symptoms that are similar to those that occur with a sleep debt. (Columbia University Department of Neurology, 2022) Even though enough sleep hours were obtained, it could be fragmented, resulting in daytime sleepiness and other health issues. Some signs of sleep debt include:

  • Feeling tired throughout the day.
  • Having trouble focusing and reacting.
  • Feeling frustrated, cranky, or worried in social situations.
  • Having difficulty judging others’ emotions.

Even after sufficient sleep hours, individuals who wake up feeling unrefreshed may need to see a sleep physician or specialist for sleep testing.

Getting Out of Sleep Debt

Fortunately, the short-term effects of sleep deprivation can be reversed with sufficient rest. To recover from sleep debt, individuals can try: (Harvard Health Publishing, 2019)

  • Getting into a normal bedtime routine.
  • Using afternoon naps in moderation.
  • Avoiding stimulants, especially in the afternoon or evening.
  • Going to bed earlier.
  • Catching up by sleeping in on the weekends.
  • Keeping a sleep diary.
  • Changing their mattress.
  • Talking with a doctor.

Although sleep deprivation affects everyone, older adults seem to rebound quicker than young adults. Individuals may initially require sleeping longer than average to compensate for the recent losses. That’s why meeting daily sleep needs and following better sleep guidelines to preserve health and well-being are important. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with insomnia or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to sleep well, avoid deprivation side effects, and restore health. Through healthy sleep practices and lifestyle accommodations, individuals can recover from sleep debt and regain the benefits of quality rest. A chiropractic therapy team can assess your condition and develop a customized treatment plan. 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.

Move Better, Live Better, Chiropractic Care

References

Harvard Health Publishing. (2019). Weekend catch-up sleep won’t fix the effects of sleep deprivation on your waistline. Harvard Health Blog. https://www.health.harvard.edu/blog/weekend-catch-up-sleep-wont-fix-the-effects-of-sleep-deprivation-on-your-waistline-2019092417861

Colten, H. R., Altevogt, B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research (Eds.). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press (US).

Columbia University Department of Neurology. (2024). Sleep Disorders. https://www.neurology.columbia.edu/patient-care/specialties/sleep-disorders?id=42069