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Tag: acupuncture

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

Hamstring Syndrome Relief for Sciatic Nerve Pain

Individuals dealing with pain in the buttocks and in the back of the thigh, along with numbness and tingling down to the bottom of the foot, may be experiencing hamstring syndrome, a condition caused by pressure on the sciatic nerve. What is the recommended treatment?

Hamstring-Syndrome Relief

The hamstrings are three muscles in the back of the thigh, extending from the pelvis or upper thigh across the back of the knee to the leg. This muscle group is important for bending the knee, straightening the hip, and stabilizing the knee. The sciatic nerve is a large nerve that runs from the lower back down the legs. It usually passes near or through these muscles, and the pelvis then runs under these muscles in the thigh. Hamstring syndrome refers to pain in the buttock and back of the thigh, often radiating down the leg, caused by compression or irritation of the sciatic nerve at the hamstring-insertion point on the ischial tuberosity, typically due to tight or scarred tissue. (Sakari Orava, 1997)

Pain Location

The pain is primarily felt in the buttock and back of the thigh, sometimes extending down the leg. It’s characterized by pressure on the sciatic nerve, which runs through the buttock and into the back of the thigh, where it supplies the hamstring muscles. (Kaiser Permanente, 2024)

Mechanism

This pressure can occur due to: (Sakari Orava, 1997) (Kaiser Permanente, 2024)

Fibrotic Bands

  • Tight, tendon-like, or scarred bands of tissue at the hamstring’s insertion point/ischial tuberosity can irritate the sciatic nerve.

Compression

  • These bands can compress the nerve, especially when sitting or during activities that involve hip flexion and knee extension.

Traction

  • The sciatic nerve can also be stretched or irritated by the hamstring tendons.

Symptoms

  • Pain in the buttock and back of the thigh may radiate down the leg.
  • Pain that is worse when sitting, stretching the hamstrings, or during activities like running. (Puranen J. & Orava S. 1988)
  • Numbness or tingling in the back of the leg

Differential Diagnosis

It’s important to differentiate hamstring syndrome from other conditions that could be causing similar symptoms, including:

  • Piriformis syndrome
  • Ischiogluteal bursitis
  • Hamstring muscle strains

Treatment

Hamstring syndrome relief may consist of the following:

Conservative

  • Initial treatment focuses on rest, ice, stretching, and over-the-counter pain relievers.

Physical Therapy

Injections

  • In some cases, injections with cortisone and numbing medicine may be used to reduce nerve inflammation and pain. (Lower Limb Surgery, 2024)

Surgery

  • In severe cases, surgery may be necessary to release the compressing bands and free the sciatic nerve. (Lower Limb Surgery, 2024)

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider about what interventions would help the most. 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.

Sciatica: Causes, Symptoms and Tips

References

Orava, Sakari. (1997). Hamstring syndrome. Operative Techniques in Sports Medicine, 5(3). https://doi.org/https://doi.org/10.1016/S1060-1872(97)80035-4.

Kaiser Permanente. (2024). Hamstring Syndrome: Care Instructions. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hamstring-syndrome-care-instructions.abr3618

Puranen, J., & Orava, S. (1988). The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American Journal of Sports Medicine, 16(5), 517–521. https://doi.org/10.1177/036354658801600515

Zion Physical Therapy. (2023). Hamstring Tendinitis Vs. Hamstring Syndrome. https://www.zionpt.com/post/hamstring-tendinitis-vs-hamstring-syndrome

Lower Limb Surgery. (2024). Hamstring Syndrome. https://www.lowerlimbsurgery.com/hamstring syndrome#:~:text=General%20Treatment%20Considerations,%E2%80%8B

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet , , , , , , , , , , , , , , , , ,

Bread Crumbs: Tips for Cooking and Substitutes

When you don’t have breadcrumbs or want to try something else, what are healthy substitutes for breadcrumbs that may yield similar results without sacrificing flavor or texture?

Bread Crumbs

Various recipes call for bread crumbs. Adding bread crumbs to sauces and other dishes helps bind and thicken wet ingredients while sprinkling bread crumbs on top of casseroles can add a crispy, crunchy texture. Individuals who follow low-carb or gluten-free meal plans or those with allergies to wheat may choose to avoid bread crumbs and dishes made with them. Wheat-free substitutes can replace bread crumbs in recipes with similar results, though the recipe may vary slightly.

Why Use Substitutes?

Individuals with food allergies or dietary restrictions may seek a substitute for bread crumbs since they may contain common allergens like wheat and gluten. Wheat is among the most common food allergies in the U.S. (Asthma and Allergy Foundation of America, 2022)

For those with allergies or sensitivities, gluten- and wheat-free bread crumbs are available to purchase at some stores, and some use alternatives out of preference. Crushing different varieties of chips, crackers, and pretzels can be used instead of bread crumbs, adding a unique flavor and texture. However, these substitutes may not be an option for recipes that call for bread crumbs to bind or thicken wet ingredients.

Nutrition

Nutrition information for 1 ounce (28.35 grams) of unseasoned bread crumbs. (USDA, FoodData Central, 2018)

  • Calories – 112
  • Fat – 1.5 grams
  • Sodium – 208 milligrams
  • Carbohydrates – 20.4 grams
  • Fiber – 1.28 grams
  • Sugars – 1.76 grams
  • Protein – 3.8 grams

Bread products like bread crumbs can be part of a balanced diet. Guidelines recommend between 3 and 5 servings of whole grains daily for adults, including whole-wheat bread. (United States Department of Agriculture, 2025)

  • The main macronutrient in bread crumbs is carbohydrates.
  • Bread crumbs are usually consumed in small amounts because they are not the main ingredient.

Substitutes

Rolled Oats or Oat Flour

Oats and oat flour are often used as gluten-free alternatives to wheat in baking. Oats by weight are:

  • Lower in calories
  • Provide more complex carbohydrates.
  • They are a richer source of dietary fiber than bread crumbs.

Like regular flour, oats can be a binder in meat-based recipes. For example, if a recipe for meatloaf or meatballs calls for bread crumbs, rolled oats or oat flour can be successfully substituted.

Ensure the oats are gluten-free for individuals with gluten allergies, celiac, or gluten sensitivity. Though oats are inherently gluten-free, they may be processed on shared equipment and exposed to cross-contamination.

Cornflakes

  • Cornflakes can also add a crunchy texture to baked recipes. While corn is inherently gluten-free, cornflakes may not be. For individuals who have allergies or sensitivities, ensure you use gluten-free cornflakes. To use cornflakes, crunch them up by adding them to a ziplock bag and pressing them on the outside.

Nuts

  • Try nuts like almonds, walnuts, pecans, and cashews to add crunch and nutrients to a recipe. They are rich in healthy fats, protein, vitamins, and minerals. Plain nuts are also gluten-free, but roasted nuts may contain a wheat-based coating. Be sure to read the labels before using them.

Seeds

  • Seeds are a nutritious substitute.
  • They offer a different crispy, crunchy texture.

Shredded Coconut

Shredded or desiccated coconut can be used for sweet or rich recipes. It is perfect for adding to baked goods, especially gluten-free varieties. The recipe may need to be adjusted slightly because coconut has more moisture than regular bread crumbs. Do a small sample first to see how the coconut works in the recipe.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, electroacupuncture, and integrated medicine protocols. 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.

Hypertension? There’s a Diet for That

References

Asthma and Allergy Foundation of America. (2022). Food allergies. https://aafa.org/allergies/types-of-allergies/food-allergies/

United States Department of Agriculture, FoodData Central. (2018). Bread crumbs, dry, grated, plain. Retrieved from https://fdc.nal.usda.gov/food-details/174928/nutrients

United States Department of Agriculture. Dietary Guidelines for Americans 2020-2025. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

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

Leg Cramp Causes Explained: Your Guide

Can understanding how leg cramps feel, their causes, and prevention help individuals with treatment options?

Leg Cramp Causes

A leg cramp is an involuntary contraction of the muscles in the leg, typically the calf muscle. It causes a sudden, sharp, and painful tightening of the muscle. They commonly occur from

  • Dehydration
  • Muscle overexertion
  • They can be a symptom of an underlying health condition, such as type 2 diabetes or kidney failure.
  • They can also be a side effect of certain medications.

Sensation

Leg cramps typically cause sudden, severe pain in the affected muscle. Individuals may also feel a hard knot or twitching of the muscle. The calf muscles are the most common site. (Harvard Health Publishing, 2024)

Causes

The underlying cause of leg cramps isn’t always known. However, work, lifestyle factors, and medical conditions can play a role. Common causes include:

  • Muscle fatigue from overuse
  • Electrolyte imbalances (e.g., potassium, magnesium)
  • Dehydration
  • Poor circulation
  • Nerve damage
  • Certain medications (e.g., statins, diuretics)

Lifestyle Risk Factors

Certain lifestyle factors and other physical characteristics can increase the risk of leg cramps and can include: (Harvard Health Publishing, 2024) (National Library of Medicine, 2020)

  • Age (those 60 and over are affected more often than younger individuals)
  • Exercising in a hot environment
  • Exercising for extended periods
  • Obesity
  • Pregnancy

Medical Factors

Leg cramps are also associated with certain medical conditions and treatments for illness. Examples include: (Maughan R. J. & Shirreffs S. M. 2019) (Garrison, S. R. et al., 2020)

  • Pinched nerves in the lower back
  • Decreased blood circulation in the legs
  • Spinal cord injury
  • Certain medications (such as statins and diuretics)
  • Allergies
  • Gastrointestinal disease (digestive tract disorders)
  • Cardiovascular disease
  • Liver failure
  • Cancer
  • Dialysis – treatment to remove excess fluid from the blood when kidneys fail.
  • Respiratory diseases of the lungs and airways
  • Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a neurological condition affecting the brain, nerves, and muscles)

Self-Care

Leg cramps often go away on their own after a few minutes. However, other self-care can help. Recommendations: (Harvard Health Publishing, 2024)

Change Body Positions

  • Moving can help relieve tension and pain.
  • If the leg cramps happen at night, stand up and take a few steps.

Massage

  • Gently rubbing the cramped muscle can help it relax.

Stretch

  • Stretching the cramping muscle can help it relax.

Apply Heat

  • If the leg cramp lasts more than a few minutes, apply a heating pad or take a warm shower to increase blood circulation to and around the muscle to help it relax.

Treatment

There are no medications specifically for treating leg cramps. However, if symptoms are caused by another medical condition, treating the underlying condition might help reduce cramp frequency. Dehydration or low electrolytes can cause leg cramps; in these cases, drinking water or electrolyte-infused beverages can help. If cramps are related to overexercising, consider reducing the intensity of your activity or exercising in a cooler environment. (Maughan R. J. & Shirreffs S. M. 2019) Magnesium supplements are usually marketed to relieve muscle cramps; they are not proven to alleviate them. (Garrison, S. R. et al., 2020)

Exercises and Stretches

Knowing which muscle to target when stretching the leg is important. If the cramp does not resolve after the first stretch attempt, try again.

Hamstring Muscle

Pain in the back of the thigh. Here’s how to stretch the hamstrings (American Academy of Orthopaedic Surgeons, 2018)

  • Lie on your back.
  • Bend both knees and rest your feet on the ground or mattress if the cramp occurs at night.
  • On the leg that is cramping, bring the knee toward your chest.
  • Interlock the fingers behind your knee.
  • Slowly straighten the knee and pull your leg toward your head until you feel a stretching sensation along the back of the thigh.
  • Hold for 30 to 60 seconds.

Calf Muscle

The calf muscle is the most common for leg cramps. To stretch the calf muscle (American Academy of Orthopaedic Surgeons, 2018)

  • Stand facing a wall.
  • Place palms flat against the wall at shoulder height.
  • Step the cramping leg away from the wall around 12 to 18 inches.
  • Keep your heels flat on the floor.
  • Keeping the back leg straight, bend the front knee slowly and lean forward until you feel a stretch along the calf.
  • Hold for 30 to 60 seconds.

Prevention

They can’t always be prevented. However, if they are related to dehydration or other lifestyle factors, individuals may be able to prevent them from occurring or decrease the frequency. Try the following: (Harvard Health Publishing, 2024)

  • Drink plenty of water.
  • Stretch the leg muscles before you go to bed.
  • Try drinking a beverage with electrolytes for longer workouts or activities in hot weather.
  • Warm up before exercise, such as with a slow jog, before getting into more intense exercises.
  • Properly cool down after a workout.
  • Stretch the leg muscles before and after exercising.
  • Maintain a healthy body weight.

Contact a Healthcare Provider

Leg cramps can sometimes signify something more serious than a Charley horse. See a healthcare provider if any of the following symptoms present (National Library of Medicine, 2020)

  • Change in skin color, including redness or a deeper tone than normal
  • Cramps that last more than a few minutes or occur frequently
  • Muscle weakness
  • Severe pain from the cramps
  • Swelling
  • Warm skin

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider about leg cramps to learn what interventions would help the most. 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.

Is Motion Key to Healing?

References

Harvard Health Publishing. (2024). How to get rid of muscle cramps in your legs. https://www.health.harvard.edu/pain/how-to-get-rid-of-muscle-cramps-in-your-legs

National Library of Medicine. (2020). Muscle cramps. Retrieved from https://medlineplus.gov/musclecramps.html

Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.), 49(Suppl 2), 115–124. https://doi.org/10.1007/s40279-019-01162-1

Garrison, S. R., Korownyk, C. S., Kolber, M. R., Allan, G. M., Musini, V. M., Sekhon, R. K., & Dugré, N. (2020). Magnesium for skeletal muscle cramps. The Cochrane database of systematic reviews, 9(9), CD009402. https://doi.org/10.1002/14651858.CD009402.pub3

American Academy of Orthopaedic Surgeons. (2018). Knee conditioning program. https://orthoinfo.aaos.org/en/recovery/knee-conditioning-program/

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet , , , , , , , , , , , , , , , , , ,

Antinutrients and Their Impact on Nutrition

Can understanding antinutrients and the importance of a balanced diet help individuals get the most out of their foods?

Antinutrients

Antinutrients are compounds in some plant foods that can reduce the body’s ability to absorb and use certain nutrients. (Petroski W., & Minich D. M. 2020) The purpose of these compounds is to protect the plants from infections and insects, which benefits the plant. It can also lower the human body’s ability to absorb nutrients properly. They are found in many grains, legumes, seeds, nuts, fruits, and vegetables. Plant-based foods high in antinutrients have beneficial nutrients, such as antioxidants, fiber, and other vitamins and minerals, and have been associated with a lower risk of chronic disease. The antinutrients may prevent the digestion and absorption of some minerals and have other negative effects that include:

  • Altered gut function
  • Increased inflammation
  • Endocrine disruption
  • Increased risk of calcium kidney stones

Common Types

Some of the main antinutrients of concern include phytates, lectins, oxalates, tannins, and phytoestrogens.

Phytates (phytic acid)

Lectins

  • They are found in nearly all foods, notably legumes and grains.
  • Lectins are proteins that bind to carbohydrates.
  • They can be harmful in high amounts or when high-lectin foods, such as beans, lentils, and wheat, are consumed raw. (Adamcová A., Laursen K. H., & Ballin N. Z. 2021)

Oxalates

  • They are found in various plant foods, including fruits, vegetables, nuts, and grains. (Mitchell T. et al., 2019)
  • Oxalates bind to certain minerals, such as calcium-forming calcium oxalate.

Tannins

  • They are found in many plant foods, such as legumes, cereal grains, nuts, cacao, leafy and green vegetables, coffee, and tea. (Ojo M. A. 2022)
  • Tannins are antioxidant-phenolic compounds that can reduce the absorption of some minerals and proteins in the body.

Phytoestrogens

  • They are found in various plant foods, such as fruits, vegetables, legumes, nuts, and seeds.
  • These estrogen-like compounds have many health benefits but may also act as endocrine disruptors (interfering with hormones). (Petroski W., & Minich D. M. 2020)

Effects on the Body

Antinutrient compounds typically bind to minerals or other nutrients, which inhibits digestion and absorption. For example,

Advantages and Disadvantages

Plant foods have long been associated with improved health and a decreased risk of some chronic diseases, such as heart disease, diabetes, cancer, stroke, and others. (Craig W. J. et al., 2021) For most, the effects of antinutrients are not of major concern after processing and cooking. The benefits and drawbacks of consuming foods high in antinutrients include: (Petroski W., & Minich D. M. 2020)

Benefits

  • Some antinutrients act as antioxidants.
  • Some have cancer-fighting abilities.
  • Some may increase immune system function.
  • They are often sources of dietary fiber and other beneficial nutrients.

Drawbacks

  • It may be difficult for some individuals to digest.
  • Phytoestrogens may behave like endocrine disruptors.
  • High amounts of oxalates can contribute to kidney stones.
  • It may decrease the absorption of some minerals.

Foods

Plant foods are the highest in antinutrient compounds, including (Petroski W. & Minich D. M. 2020)

  • Coffee
  • Some teas
  • Cacao
  • Grains
  • Nuts, such as cashews, hazelnuts, and almonds
  • Legumes, such as beans, peas, peanuts, lentils and soybeans
  • Seeds like flaxseeds, sunflower seeds, and sesame seeds
  • Fruits and vegetables include apples, stone fruits, some berries, dark leafy greens, and potatoes.

Reducing Intake

Processing and cooking foods high in antinutrients can help reduce the amount of antinutrient compounds (Petroski W. & Minich D. M., 2020) (Harvard T.H. Chan School of Public Health, 2022)

  • Soaking and sprouting
  • Fermentation
  • Cooking methods to minimize antinutrient content, like boiling, steaming
  • Autoclaving – a cooking process that uses high pressure and heat to cook and sterilize food.
  • Peeling the skins of fruits and nuts is effective for reducing tannins.
  • Combining foods to enhance nutrient absorption.
  • For example, pairing high-oxalate foods with high-calcium foods.

Combining different cooking and processing methods can completely degrade and reduce many antinutrient compounds. The exception is phytoestrogens, where boiling, steaming, and fermentation can increase antinutrients. (Petroski W. & Minich D. M., 2020)

Balancing Nutrition

The Dietary Guidelines for Americans recommend consuming nutrient-dense foods across all food groups. (U.S. Department of Agriculture, 2020)

  • Including various foods in one’s diet will help ensure one gets a diverse range of nutrients to fuel the body properly.
  • When consuming high-antinutrient foods, use processing and cooking methods known to reduce antinutrient compounds.
  • Think about making balanced food pairings to optimize nutrient absorption and minimize antinutrient intake.

For example, combining foods high in vitamin C with foods containing iron in the same meal or snack can enhance iron absorption, opposing the antinutrient activity of phytates. (National Institutes of Health Office of Dietary Supplements, 2024)

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals concerned about antinutrients in their diet and who want individualized advice on how to get the most out of the food they eat should consider consulting with a registered dietitian nutritionist or another healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.

Smart Choices, Better Health

References

Petroski, W., & Minich, D. M. (2020). Is There Such a Thing as “Anti-Nutrients”? A Narrative Review of Perceived Problematic Plant Compounds. Nutrients, 12(10), 2929. https://doi.org/10.3390/nu12102929

Gupta, R. K., Gangoliya, S. S., & Singh, N. K. (2015). Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. Journal of food science and technology, 52(2), 676–684. https://doi.org/10.1007/s13197-013-0978-y

Adamcová, A., Laursen, K. H., & Ballin, N. Z. (2021). Lectin Activity in Commonly Consumed Plant-Based Foods: Calling for Method Harmonization and Risk Assessment. Foods (Basel, Switzerland), 10(11), 2796. https://doi.org/10.3390/foods10112796

Mitchell, T., Kumar, P., Reddy, T., Wood, K. D., Knight, J., Assimos, D. G., & Holmes, R. P. (2019). Dietary oxalate and kidney stone formation. American journal of physiology. Renal physiology, 316(3), F409–F413. https://doi.org/10.1152/ajprenal.00373.2018

Ojo, M. A. (2022). Tannins in Foods: Nutritional Implications and Processing Effects of Hydrothermal Techniques on Underutilized Hard-to-Cook Legume Seeds-A Review. Preventive nutrition and food science, 27(1), 14–19. https://doi.org/10.3746/pnf.2022.27.1.14

Craig, W. J., Mangels, A. R., Fresán, U., Marsh, K., Miles, F. L., Saunders, A. V., Haddad, E. H., Heskey, C. E., Johnston, P., Larson-Meyer, E., & Orlich, M. (2021). The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients, 13(11), 4144. https://doi.org/10.3390/nu13114144

Harvard T.H. Chan School of Public Health. (2022). Are anti-nutrients harmful? https://nutritionsource.hsph.harvard.edu/anti-nutrients/

U.S. Department of Agriculture. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

National Institutes of Health Office of Dietary Supplements. (2024). Iron. Retrieved from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/

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

Personal TENS Devices: A Modern Approach to Pain Relief

For individuals managing chronic pain conditions, can incorporating a personal TENS device help?

Personal TENS Device

Almost all physical therapy, chiropractic, acupuncture, and massage clinic healthcare providers offer TENS (transcutaneous electrical nerve stimulation) therapy. Individuals can buy a TENS unit for on-the-go and home care use. A personal TENS unit is a small, battery-powered device that uses low-voltage electrical currents delivered through electrodes placed on the skin to help relieve pain.

How It Works

TENS units work by stimulating nerve fibers in pain, which can help block pain signals from reaching the brain or by stimulating the release of endorphins, the body’s natural pain-killing chemicals.

Uses

TENS units are used to treat a variety of conditions, including:

  • Arthritis 
  • Muscle cramps
  • Neck pain
  • Back pain
  • Pelvic pain
  • Knee pain
  • Osteoarthritis
  • Fibromyalgia
  • Tendinitis
  • Bursitis
  • Diabetes-related neuropathy
  • Pelvic pain from periods or endometriosis

Features

Portability

  • TENS units are small, lightweight, and portable, making them convenient for home or on the go. It can be held in a pocket or clipped to a belt. (National Health Service UK, 2025)

Electrodes

  • The unit is connected to a series of electrodes placed on the skin to deliver the electrical charge.

Adjustable Settings

  • Many TENS units allow users to adjust the electrical pulses’ intensity, frequency, and duration.

Benefits

Non-Invasive

  • TENS therapy is a non-invasive method for relieving pain.

Drug-Free

  • It can provide pain relief without the need for medication.

Convenient

  • TENS units are small, portable, and relatively discrete.

Precautions

Consult a healthcare provider before using a TENS device to ensure its safety for you and your injury/condition. The treatment should not be used for individuals who are pregnant, have epilepsy, poor sensation, a heart problem, a pacemaker, or another electrical or metal implant in their body. (National Health Service UK, 2025) The electrodes should not be placed on certain areas of the body, including (Teoli D, Dua A, An J. 2025)

  • Head
  • Eyes
  • Mouth
  • Front of the Neck
  • Chest and upper back at the same time
  • Numb areas
  • Broken skin
  • Tumors

There is a minor risk of skin irritation, particularly if allergic to the adhesive pads.

Effectiveness

Researchers are still determining how effective TENS units are for relieving and reducing pain. A study found that TENS was effective in relieving pain for patients with fibromyalgia. (Dailey D. L. et al., 2013) Another study suggested that TENS may improve bone pain for cancer patients, but the results were inconclusive because of the limited number of randomized trials. (Vance C. G. et al., 2014)

Research suggests that some factors can impact the effectiveness of the intervention. Varying the intensity and frequency may help it be more effective so the body doesn’t develop a tolerance to it. In addition, using the electrodes in areas that are acupuncture points may help to reduce pain. While further study is needed, TENS is considered a safe pain-relief option for many conditions because it’s non-invasive and doesn’t require medication. (Vance C. G. et al., 2014)

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals interested in trying a personal TENS unit should consult their healthcare provider. They may be able to refer them to a physical therapist, who can show them which type and how to use it for their particular condition. 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.

Don’t Ignore Post-Accident Pain

 

References

National Health Service UK. (2025). TENS (transcutaneous electrical nerve stimulation). https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/

Teoli, D., Dua, A., & An, J. (2025). Transcutaneous Electrical Nerve Stimulation. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30725873

Dailey, D. L., Rakel, B. A., Vance, C. G. T., Liebano, R. E., Amrit, A. S., Bush, H. M., Lee, K. S., Lee, J. E., & Sluka, K. A. (2013). Transcutaneous electrical nerve stimulation reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain, 154(11), 2554–2562. https://doi.org/10.1016/j.pain.2013.07.043

Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain management, 4(3), 197–209. https://doi.org/10.2217/pmt.14.13

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet, Gut Health , , , , , , , , , , , , , , , , , ,

Enzymes and Their Role in Biological Functions

Enzymes’ function is to help trigger bodily processes ranging from digestion to blood clotting to growth. What is the best way to support enzyme production?

Enzymes

Enzymes are proteins that act as biological catalysts. They cause and speed up crucial chemical reactions and help the body complete necessary chemical reactions. They are vital for many biological processes, including digestion, metabolism, and molecule building and breaking down. This includes breaking down food, facilitating growth, and forming blood clots. Too little of a certain type can lead to serious health implications like a fatal buildup of toxins. Individuals missing a certain kind of enzyme or having too little of it can develop serious health conditions.

Function

They help speed up chemical reactions in the body (National Human Genome Research Institute, 2025). They facilitate chemical reactions in everything from digesting food to muscle growth. Enzymes facilitate this by binding to a cell, creating the reactions needed. With enzyme binding, chemical reactions can occur without destroying the cell. (Nemours KidsHealth, 2023) Each cell in the body has thousands of enzymes to help facilitate all the complex reactions to maintain health. (National Human Genome Research Institute, 2025)

Factors Affecting Production

In healthy individuals, the body produces the enzymes it needs. However, metabolic disorders can occur if the body does not produce enough of a certain type. (Kennedy Krieger Institute, 2025) These disorders can be serious and are usually caused by a genetic malfunction that impacts production.

Types

There are thousands of different types. Digestive enzymes, for example, aid in the breakdown of food and convert it into energy. Common enzymes that are critical for health include (Nemours KidsHealth, 2023)

Amylase

  • Digestive helps break down starches.

Aspartate aminotransaminase (AST) and Alanine Aminotransaminase (ALT)

  • Help the liver convert sugar into energy.

Creatine Kinase (CK)

  • Helps muscles create energy.

DNA Polymerase

  • Facilitates growth by allowing DNA to duplicate.

Glucose-6-Phosphate Dehydrogenase

  • Keeps red blood cells healthy by preventing damage to the cell.

Lipase

  • A digestive enzyme that helps break down fats and oils.

Protease

  • Digestive helps break down proteins.

Thrombin

  • Causes blood to clot.

Deficiencies

If the body doesn’t make enough of a certain enzyme, it cannot undergo the bodily processes that the enzyme helps facilitate. This can lead to a variety of symptoms. Some are minor, like not being able to eat lactose. Others are serious, like developmental delays caused by the build-up of toxins. (Kennedy Krieger Institute, 2025) Usually, these deficiencies are caused by genetics.

Types

There are various deficiencies. Some are very rare, while others can lead to conditions such as: (Nemours KidsHealth, 2023)

Lactose Intolerance

  • This is caused by not having enough of the enzyme that breaks down lactose, a sugar found in milk, leading to gas and bloating.

Tay-Sachs Disease

  • An often fatal disease caused by a missing hexosaminidase, which is responsible for breaking down fats

Gilbert’s Syndrome

  • This is caused by a missing enzyme that removes waste product (bilirubin) from the blood, leading to bilirubin buildup and
  • Jaundice or yellowing of the skin and whites of the eyes

Galactosemia

  • This leads to slow growth and trouble gaining weight, which is caused by the missing galactose-1-phosphate uridylyltransferase (GALT), which helps break down a sugar called galactose.

Phenylketonuria (PKU)

  • This is caused by having too little phenylalanine hydroxylase, which breaks down a protein called phenylalanine, causing brain damage.

Morquio Syndrome

  • This is caused by having too few enzymes that break down glycosaminoglycans, a type of sugar molecule.
  • This leads to bone and growth abnormalities.

Wilson’s Disease

  • A liver disease is caused by a missing protein that helps break down copper in the body.

Enzyme Production Support

Eat a healthy, well-balanced diet of fruits and vegetables to support enzyme production. Avoid processed foods, especially those that are very fatty (Johns Hopkins Medicine, 2025). The body produces all the necessary enzymes unless the individual has a genetic condition. Supplements aren’t usually required, but they can help with lactose intolerance or digestion in cystic fibrosis patients. (Nemours KidsHealth, 2023)

One supplement type, pancreatic enzyme replacement therapy (PERT), is available. PERT is an FDA-regulated prescription medication prescribed to patients with serious illnesses such as cystic fibrosis. (U.S. Food and Drug Administration, 2019)

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.

Chiropractic Care and Metabolism: The Hidden Link

References

National Human Genome Research Institute. (2025). Enzyme. Retrieved from https://www.genome.gov/genetics-glossary/Enzyme

Nemours KidsHealth. (2023). Enzymes. https://kidshealth.org/en/parents/enzymes.html

Kennedy Krieger Institute. (2025). Metabolic disorders. https://www.kennedykrieger.org/patient-care/conditions/metabolic-disorders

Johns Hopkins Health. (2025). Digestive enzymes and digestive enzyme supplements. https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements#:~:text=You’re%20better%20off%20building,your%20diet,%20especially%20fried%20foods.

U.S. Food and Drug Administration. (2019). FDA approves new breakthrough therapy for cystic fibrosis. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-breakthrough-therapy-cystic-fibrosis

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

Cupping as Alternative Medicine for Pain Relief

For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?

Cupping Therapy

This ancient treatment is gaining public acceptance, and awareness has heightened, with various individuals and athletes being seen with round marks on their shoulders and backs. It is a pain treatment that, like acupuncture, comes from traditional Chinese medicine, or TCM. The therapy involves placing glass, silicone, or bamboo cups on the skin to create suction. The treatment is an alternative medicine technique used to relieve musculoskeletal pain. The suction is believed to promote healing (Cleveland Clinic, 2023)

Increasing Blood Circulation

  • The suction draws blood to the area, which can help reduce inflammation and promote healing.

Releasing Muscle Tension

  • The suction can stretch and pull on muscles, which can help relieve pain and tightness.

Breaking Up Adhesions

  • The suction can help break up scar tissue and adhesions that can cause pain and restricted movement.

Detoxifying the Body

  • Some practitioners believe that cupping can help remove toxins from the body.

It is typically performed by a trained practitioner who places the cups on the skin and leaves them in place for several minutes. The cups can be placed on various body areas, including the back, neck, shoulders, and legs. (Cleveland Clinic, 2023)

Benefits

  • Pain relief, especially for muscle and joint pain
  • Reduced inflammation
  • Improved circulation
  • Increased range of motion
  • Detoxification

Procedure

The medical practice involves creating skin suction using glass, ceramic, or plastic cups. How it’s done:

Preparation

  • The practitioner cleans the area where the cups will be placed.
  • They may apply oil or massage cream to the skin for easier movement of the cups.

Techniques

Dry

  • The practitioner heats the inside of the cup with a flame or pump, creating a vacuum.
  • The cup is then placed on the skin, which adheres due to the negative pressure.
  • The cup remains on the skin for several minutes, allowing the suction to draw blood and tissue into the cup.

Wet

  • Like the dry technique, the practitioner makes small incisions in the skin before applying the cup.
  • This allows blood to flow into the cup, creating a more intense suction.

Aftercare

  • The cups are removed, and the practitioner may apply pressure to the area to stop bleeding.
  • The patient is advised to avoid strenuous activity and hot showers for a few hours after the treatment.

The benefits of therapy include opening pores, stimulating blood flow, filtration, and balancing energy flow through the body. It’s often combined with massage and acupuncture. (Cleveland Clinic, 2023)

It also aims to alleviate symptoms of systematic diseases like diabetes and hypertension. However, more research is needed to see and fully analyze the effects of the treatment. (Aboushanab T. S., & AlSanad S. 2018)

Risks

The therapy is generally safe when done correctly and by a licensed professional. However, there is some risk of side effects like skin discoloration and scarring. Reports of rare side effects include bleeding inside the skull from cupping on the scalp and anemia from repeated wet techniques. (National Center for Complementary and Integrative Health, 2018) Other side effects can include:

Bruising

  • It can cause temporary bruising at the site of the cups.

Skin Irritation

  • Some people may experience skin irritation or burns from the suction.

Infection

  • There is a small risk of infection if the cups are not properly sterilized.

Who should avoid the therapy?

Those with skin conditions like eczema and psoriasis should avoid cupping, as it may worsen them. (National Center for Complementary and Integrative Health, 2018) 

Injury Medical Chiropractic & Functional Medicine Clinic

It is important to consult with a healthcare professional before trying any new treatment, especially if you have any underlying health conditions. 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.

Beyond Medicine: The Power of Chiropractic Care

References

Cleveland Clinic. (2023). Cupping Therapy. https://my.clevelandclinic.org/health/treatments/16554-cupping

Aboushanab, T. S., & AlSanad, S. (2018). Cupping Therapy: An Overview from a Modern Medicine Perspective. Journal of acupuncture and meridian studies, 11(3), 83–87. https://doi.org/10.1016/j.jams.2018.02.001

National Center for Complementary and Integrative Health. (2018). Cupping. Retrieved from https://www.nccih.nih.gov/health/cupping

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Exercises, Physio, Sporting , , , , , , , , , , , , , , , , , ,

Quadriceps Stretches: Essential for Leg Health

Can stretching quadriceps help relieve stiffness and pain and improve flexibility for individuals with consistently tight quadriceps?

Quadriceps Stretches

Walking, running, biking, and other daily activities can tighten the quadriceps muscles. The quadriceps are four muscles in the front of the thigh that extend the leg and strengthen the knee. Stretching the quadriceps may be a part of a home or gym exercise program or physical therapy treatment to maintain quadricep flexibility. Resting the quadriceps with an exercise program can greatly maximize mobility and prevent injury.

Tight quadriceps may sometimes result from injuries such as patellofemoral stress syndrome or iliotibial band friction syndrome. The quads may also become tight for individuals with spinal stenosis or other related problems with the lower back. (International Sports Sciences Association, 2023) Ely’s test, also known as the Duncan-Ely test, is one way to determine whether your quadriceps are tight. It is a physical examination used to assess the flexibility and potential spasticity of the rectus femoris muscle (a quadriceps muscle) by passively flexing the patient’s knee. Lie on your stomach and try to touch your foot to your buttocks. If you can’t, the rectus femoris, one of the main muscles, may be tight and benefit from quadricep stretches. (Olivencia, O. et al., 2020)

Safety and Precautions

Before trying this or any other exercise program, consult a healthcare provider to ensure exercise is safe for you and your conditions. A professional can help diagnose any overuse injury that might be causing tight quadriceps. Quadriceps stretches will be a little more comfortable after warming up. A few minutes of walking or biking will warm the quadriceps muscles to stretch more easily.

Stretches

To stretch the quadriceps, try the standing, side-lying, and prone quadriceps stretch once fully warmed up and after a workout. Individuals who frequently experience quadriceps tightness should stretch them daily. Incorporate all or some of these stretches into a cool-down or off-day flexibility routine.

Standing Stretch

The standing quadriceps stretch can be done anywhere in the office, gym, or outside. All you need is a place to stand. Here is how:

  • While standing, hold onto a countertop or back of a chair to help with balance.
  • Bend your knee by grasping your ankle.
  • Move your foot toward your buttocks.
  • Gently pull on your ankle to bend your knee as far as possible.
  • Maintain position for 30 seconds.
  • Return to the standing position.
  • Repeat the exercise 3 to 5 times with each leg.
  • Stop stretching if there are any sharp pains.

Side-Lying Stretch

The side-lying quad stretch lengthens the quadriceps. On the floor in a supported position can help focus on the stretch. Here’s how:

  • Lie on your side.
  • Bend the knee of your top leg as far as you can, gently pulling with your hand.
  • Maintain position for 30 seconds.
  • Return to the starting position.
  • Repeat the exercise 3 to 5 more times with each leg.

Prone Stretch

Stretch the quadriceps while lying on your stomach. In this position, the floor helps to stabilize the pelvis, minimizing rocking and maximizing the stretch. To do the stretch:

  • Lie on your stomach.
  • Bend your knee back as far as you are able.
  • Grab your ankle to pull your foot toward your buttocks.
  • Maintain position for 30 seconds.
  • Return to the starting position.
  • Repeat the exercise 3 to 5 more times with each leg.

If you have difficulty reaching your ankle, pull the leg up, wrap a towel or strap around the ankle, and use it to pull. This can help stretch the quadriceps effectively even if you cannot reach the ankle easily.

Injury Medical Chiropractic & Functional Medicine Clinic

Consult a healthcare provider or physical therapist to learn the recommended quadriceps stretches or other strengthening exercises. Keeping the quadriceps healthy will help keep the knees moving and maximize functional mobility. 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.

Chiropractic Care For Leg Instability

References

International Sports Sciences Association. (2023). How to Release Tight Quads in 2 Simple Steps. ISSA. https://www.issaonline.com/blog/post/how-to-release-tight-quads-in-2-simple-steps

Olivencia, O., Godinez, G. M., Dages, J., Duda, C., Kaplan, K., Kolber, M. J., Kaplan, & Kolber (2020). THE RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE ELY AND ACTIVE KNEE EXTENSION TESTS. International journal of sports physical therapy, 15(5), 776–782. https://doi.org/10.26603/ijspt20200776

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

Sleep Cervical Neck Roll for Better Rest

Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?

Sleep Cervical Neck Roll

Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.

For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.

Neck Support During Sleep

The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)

  • Individuals can purchase a cervical roll online or at a store or pharmacy.
  • Individuals can also contact a physical therapist to help them obtain a cervical roll.

Making Your Own

Making a cervical roll is simple to do. Here’s how:

  • Using a hand towel.
  • Fold it in half.
  • Slide the towel into the pillowcase along the lower edge.
  • Be sure the towel is tucked in so it doesn’t slip out.
  • Individuals can place tape around it so it stays in the rolled shape.

The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)

If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.

Injury Medical Chiropractic & Functional Medicine Clinic

A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. 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.

The Road To Recovery: Chiropractic Care

References

Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. https://doi.org/10.1186/s13063-015-0770-6

Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. https://doi.org/10.1186/s13643-019-1125-2

Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. https://doi.org/10.2174/1874325001307010530

Harvard Health Publishing. (2022). Say “good night” to neck pain. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain

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

Exercising Before Bed: Impact on Your Sleep Cycle

What type of exercise is recommended for individuals who want to exercise before bed?

Exercising Before Bed

Exercising sounds like a good way to tire the mind and body before bed. However, research shows that moderate to vigorous exercise later in the day can negatively impact sleep quality. (Alkhaldi E. H. et al., 2023)

  • To improve sleep, it is recommended that you exercise in the morning or earlier in the day, at least four hours before bed.
  • Individuals who exercise later should aim for lighter activities, such as non-strenuous walking or gentle, restorative yoga.
  • Light physical activity, like a slow walk after dinner, is OK.

Advantages

Daily exercise improves sleep quality. (Johns Hopkins Medicine, 2025) Mild exercise before bed and engaging in light activities like walking or stretching can positively affect health (Hijikata Y, Yamada S. 2011). These include:

  • Decrease muscle tension
  • Improve digestion
  • Improve blood sugar regulation
  • Relax the mind and body

Disadvantages

The nervous system naturally switches between active and calm. It is ready to work and engage in physical activities when it is active. When it is resting, sleep occurs. Activating the nervous system before bed can affect sleep, and exercising can affect body temperature, producing sleep challenges. Typically, body temperature decreases as the body prepares for sleep. Exercising before bed can increase core temperature and disrupt the process. (Szymusiak R. 2018) Moderate or vigorous physical activity close to going to sleep can: (Alkhaldi E. H. et al., 2023)

  • Make it more difficult to fall asleep
  • This leads to more waking up during the night.
  • Decrease sleep quality

Recommended Types of Exercise

Pre-bedtime activities should not be vigorous or engaging enough to make the body and mind more alert. Some exercises to calm the body and mind before bed include: (Sleep Foundation, 2023)

Restorative Yoga

  • Yoga Nidra and other low-intensity yoga can help promote sleep.
  • More intense forms of yoga, such as vinyasa/flow, should be done earlier.

Tai Chi

  • A Chinese practice that incorporates slow, gentle movements and focuses on breathing to promote peace and relaxation.

Slow Walking

  • Walking at a leisurely pace can help the body unwind and relax.

A slow heart rate and breathing indicate that the activity is calming and not stimulating.

Exercises to Avoid

Moderate to high-intensity workouts before bed that increase breathing and heart rate can disrupt sleep. Individuals who struggle to fall asleep or get restful sleep should try reducing the intensity of certain exercises or avoiding them one to two hours before bed. Examples of moderate to vigorous exercises include: (American Heart Association, 2024)

  • Gardening or heavy yard work
  • Running
  • Brisk walking
  • Cycling
  • Dancing
  • Sports activities

Working Out In The Evening

Sometimes, exercising later in the day or close to bedtime is the only time to get physical activity. If this is the case, late exercise is better than no exercise at all, but there are ways to lessen its impact on sleep, including:

  • Light physical activity, like walking, can be done up to an hour before bed.
  • Do more intense exercises at the beginning of the workout.
  • End the workout with a cooldown, like walking or stretching, to relax the mind and body.
  • Know how your workout schedule impacts your sleep, and adjust as necessary.

How Long After Working Out to Go To Sleep?

For individuals who want restful and uninterrupted sleep, experts recommend waiting one to two hours after a moderate or vigorous workout to go to bed. (Harvard Health Publishing, 2024) (Johns Hopkins Medicine, 2025)

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.

Optimizing Your Wellness

References

Alkhaldi, E. H., Battar, S., Alsuwailem, S. I., Almutairi, K. S., Alshamari, W. K., & Alkhaldi, A. H. (2023). Effect of Nighttime Exercise on Sleep Quality Among the General Population in Riyadh, Saudi Arabia: A Cross-Sectional Study. Cureus, 15(7), e41638. https://doi.org/10.7759/cureus.41638

Johns Hopkins Medicine. (2025). Exercising for better sleep. https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercising-for-better-sleep

Hijikata, Y., & Yamada, S. (2011). Walking just after a meal seems to be more effective for weight loss than waiting for one hour to walk after a meal. International journal of general medicine, 4, 447–450. https://doi.org/10.2147/IJGM.S18837

Szymusiak R. (2018). Body temperature and sleep. Handbook of clinical neurology, 156, 341–351. https://doi.org/10.1016/B978-0-444-63912-7.00020-5

Sleep Foundation. (2023). Bedtime routines for adults. https://www.sleepfoundation.org/sleep-hygiene/bedtime-routine-for-adults

American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Harvard Health Publishing. (2024). Does exercising at night affect sleep? https://www.health.harvard.edu/staying-healthy/does-exercising-at-night-affect-sleep