Care is the cornerstone of our practice

Visit our Location
11860 Vista Del Sol Dr Suite 105,
El Paso, TX 79936
Give us a Call
+1 (915) 412-6680
Send us a Message
support@chiromed.com
Opening Hours
Mon-Thu: 7 AM - 7 PM
Fri - Sun: Closed

Tag: Clinic

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

Bone Growth Stimulator in Post-Injury Healing

Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?

Bone Growth Stimulator

Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.

How They Work

Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn’t heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)

  • They come in various shapes, sizes, and technologies depending on the location of the fracture.
  • The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
  • The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
  • Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.

Electrical Stimulation

  • Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.

Ultrasound Stimulation

  • They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.

Implantable vs. External

  • Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.

The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.

Effectiveness

Studies of bone stimulator effectiveness suggest two benefits:

  1. Less pain is associated with the bone healing process.
  2. Faster fracture healing.

However, these studies haven’t shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)

  • While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
  • Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
  • It’s important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it’s the right treatment option.

When Stimulation is Necessary

Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)

Nonunion Fractures

  • When a fracture doesn’t heal within the expected timeframe.
  • Open fractures
  • Stress fractures
  • Scaphoid bone fractures
  • Talus fractures

Failed Fusions

  • When a spinal fusion hasn’t been successful.

High-Risk Patients

  • For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications

Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

From Injury to Recovery with Chiropractic Care

References

U.S. Food & Drug Administration. (2022). AccelStim Bone Growth Stimulator – P210035. Retrieved from https://www.fda.gov/medical-devices/recently-approved-devices/accelstim-bone-growth-stimulator-p210035#:~:text=What%20is%20it?,the%20transducer%20to%20the%20fracture

Childs, S. G. (2003). Stimulators of bone healing. Biologic and biomechanical. Orthopedic nursing, 22(6), 421–428. https://doi.org/10.1097/00006416-200311000-00010

Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. https://doi.org/10.1038/srep31724

Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What’s all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. https://doi.org/10.4103/0019-5413.50844

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

Sauerkraut and Its Incredible Health Benefits

Can incorporating sauerkraut into one’s diet help promote healthy gut bacteria?

Sauerkraut

Sauerkraut, a fermented cabbage food, is a great source of probiotics and fiber, both of which can contribute to gut health. It’s a living food containing various microbial strains and can help improve digestion, reduce inflammation, and improve overall gut health. (Shahbazi R. et al., 2021)

Fermented foods like sauerkraut have live cultures that promote the growth of beneficial probiotics, bacteria that provide powerful health benefits. Probiotics also help make foods more digestible, increasing the gut’s ability to absorb the vitamins and minerals they contain. A study found that fermented cabbage may help protect intestinal cells from inflammatory damage more than raw cabbage. (Wei L., & Marco M. L., 2025)

Homemade sauerkraut likely contains more live cultures than store-bought since processing may destroy some of the healthy bacteria. (National Institutes of Health Office of Dietary Supplements, 2023) Depending on which supplement is chosen, sauerkraut may have a greater diversity of probiotic strains. This is because an oral supplement has a known quantity and strain of probiotics. Individuals who want to add probiotics to their diet for potential gut health benefits should take a food-first approach, which is generally recommended over oral supplements. (National Institutes of Health, 2025)

Look at the Benefits

Probiotics

  • Sauerkraut contains lactic acid bacteria, which are beneficial bacteria that can help support the immune system and reduce inflammation. (Healthline, 2023)

Fiber

  • Sauerkraut is a robust source of fiber, which aids in digestion and can help you feel full longer.

Digestion

Anti-inflammatory

Gut Microbiome

  • Sauerkraut can help diversify and improve the composition of the gut microbiome, leading to various health benefits. (Healthline, 2023)

IBS symptoms

How to incorporate sauerkraut into one’s diet

Check the Ingredients

Option for unpasteurized

  • Look for sauerkraut that is labeled raw or naturally fermented to ensure it contains live probiotics.

Try to Eat Regularly

  • Aim to include sauerkraut in your diet a few times a week to reap the benefits. (Healthline, 2023)

Pair with Other Gut-Healthy Foods

  • Sauerkraut can be eaten alone or paired with other fermented foods, such as yogurt, kimchi, or chard, to promote gut health.

What to consider

Cabbage Allergy

  • Individuals who have a cabbage allergy or histamine intolerance should avoid sauerkraut.

Sodium

MAOI Medications

  • Consult with a doctor before adding sauerkraut to your diet if you are taking monoamine oxidase inhibitors (MAOIs).

Start small and learn how you like to eat sauerkraut, which can be as a condiment, side dish, or sandwich ingredient.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. 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.

Body In Balance: Chiropractic, Fitness, and Nutrition

References

Shahbazi, R., Sharifzad, F., Bagheri, R., Alsadi, N., Yasavoli-Sharahi, H., & Matar, C. (2021). Anti-Inflammatory and Immunomodulatory Properties of Fermented Plant Foods. Nutrients, 13(5), 1516. https://doi.org/10.3390/nu13051516

Healthline. (2023). 8 Surprising Benefits of Sauerkraut (Plus How to Make It). https://www.healthline.com/nutrition/benefits-of-sauerkraut#nutrients

Medical News Today. (2023). What are the benefits of eating sauerkraut? https://www.medicalnewstoday.com/articles/health-benefits-of-sauerkraut

Wei, L., & Marco, M. L. (2025). The fermented cabbage metabolome and its protection against cytokine-induced intestinal barrier disruption of Caco-2 monolayers. Applied and environmental microbiology, e0223424. Advance online publication. https://doi.org/10.1128/aem.02234-24

National Institutes of Health Office of Dietary Supplements. (2023). Probiotics. Retrieved from https://ods.od.nih.gov/factsheets/Probiotics-Consumer/

National Institutes of Health. (2025). Probiotics. Retrieved from https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/

U.S. Department of Agriculture. (2018). Sauerkraut, canned, solids and liquids. Retrieved from https://fdc.nal.usda.gov/food-details/169279/nutrients

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

Muscles Retighten: Why Ongoing Care Is Essential

Why do the muscles retighten days or weeks later for individuals who have received massage or chiropractic adjustments?

Muscles Retighten

Muscles can retighten again days or weeks after chiropractic treatment and/or a massage. A few factors may cause this.

  • Muscle memory: The body’s natural tendency to return to its previous state of tension.
  • This includes all the unhealthy postures/positioning 
  • Delayed inflammatory response.
  • The body’s natural healing process
  • How muscles respond to manipulation
  • The need for ongoing maintenance of muscle health

After a massage, muscles can experience a temporary increase in soreness or tightness as the body heals from any minor damage or inflammation caused by the massage. Additionally, if the underlying issue causing muscle tightness is not addressed, the muscles may revert to their original state over time. (Cleveland Clinic, 2024)

Causes

Causes for muscles to retighten.

Underlying Issues

  • If the root cause of the muscle tightness is not addressed, such as unhealthy posture, injuries, repetitive motions, or muscle imbalances, it can lead to further complications.
  • In that case, the muscles may return to their original state after a few days or weeks.

Delayed Onset Muscle Soreness (DOMS)

  • For example, muscles feel sore after intense exercise, and individuals can also experience DOMS after a massage, especially if they are particularly tight or if it’s been a while since their last massage. (Healthline, 2020)

Delayed Inflammatory Response

  • Massage can sometimes cause microscopic tears or inflammation in muscle tissue, which triggers the body’s natural healing process.
  • This response can cause soreness and temporary tightness, as the body repairs the damaged tissue even after the initial massage. (Essential Chiropractic, 2025)

Muscle Memory

  • The body tends to revert to habitual patterns of muscle tension, especially if the underlying cause of the tightness isn’t addressed.
  • Muscles can retain how they were manipulated during the massage and may revert to their original tightness if they haven’t been consistently relaxed.

Muscle Guarding

  • The individual and body can subconsciously tense muscles to avoid pain or soreness, even after the massage. 
  • This muscle guarding can counteract the benefits of the massage and lead to a renewed cycle of tension. (Bhimani R. H., & Soomar D. 2019)

Muscle Health Maintenance

  • Regular Maintenance
  • Muscles need consistent care to maintain their optimal state of health and function.
  • Regular massages and other lifestyle changes, such as stretching and strengthening exercises, can help maintain muscle flexibility and reduce the likelihood of muscle tightness returning.

Individual Variation

  • Factors like the type of massage received, the frequency of massages, and individual body responses can all influence how long a massage’s benefits last. (Cleveland Clinic, 2024)

Massage Treatment

Muscles can retighten after a massage due to the body’s response to the pressure and manipulation during the treatment. This can include individual sensitivity to massage, the type of massage, and hydration levels, which can also play a role.

Type of Massage

  • Deep tissue massage, which focuses on specific muscle groups and applies deeper pressure, may cause more soreness than other types of massage.
  • Some individuals may be more sensitive to massage and experience soreness, even with a gentle massage. (Cleveland Clinic, 2024)

Muscle Fiber Manipulation

  • Deep tissue massage can break down spasms or microtears in muscle fibers, leading to soreness.
  • This is similar to the microscopic tears that occur during exercise, which are necessary for muscle repair and growth.

Dehydration

  • Individuals who are not adequately hydrated may experience increased soreness after a massage. (Cleveland Clinic, 2024)

Lactic Acid Buildup

  • During an intense massage, particularly deep tissue, lactic acid can build up in the muscles, leading to soreness and tightness. 
  • (Healthline, 2020)

Muscle Tensions

  • If the muscles were particularly tense or knotted before the massage, the manipulation could lead to soreness as the knots get worked out.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Secrets of Optimal Wellness

References

Cleveland Clinic. (2024). How to Relieve Muscle Soreness After a Massage. https://health.clevelandclinic.org/why-does-my-body-feel-worse-after-a-massage

Healthline. (2020). How to Relieve Sore Muscles After a Massage. https://www.healthline.com/health/sore-after-massage#causes-of-soreness

Essential Chiropractic and Physiotherapy. (2025). Muscle Ache After Massage: Common Causes and Relief. https://essentialchiropractic.co.uk/muscle-ache-after-massage-common-causes-and-relief/#:~:text=Post%2Dmassage%20soreness%20is%20a,hours%20as%20the%20muscles%20recover.

Bhimani, R. H., & Soomar, D. (2019). Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 44(5), 271–281. https://doi.org/10.1097/rnj.0000000000000151

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

Pace Running: How to Work with Pacers

Can pace running help runners concentrate on other things, like breathing, form, or mental toughness?

Pace Running

Running is a sport many participate in and doesn’t require any equipment—only quality running shoes. Running in races comes with various physical and mental challenges. Some runners enjoy running in races and marathons but want to perfect their abilities and techniques, become more consistent, finish in a certain time, or pass a personal record. This is where pace running or working with a pace runner can help achieve those goals.

What is a Pace Runner?

A pace runner, or pacer, is an experienced runner who can run at a set pace for a long time. The pacer sets the speed so the runner can focus on running. Pacers run in races or marathons to help set the pace for a runner or runners. There are different reasons why professional and amateur runners work with a pace runner. Professional runners often use pace runners to work on techniques and help reach new levels in their running, while amateur runners can work on improving their overall running abilities. There are three typical types of pacers.

Race Pacer

  • Pacers wear or carry signs to make it easier for the runners and can often run split times.
  • A split time is the time it takes to run a certain distance.
  • Typically, these pacers will run at an even pace.
  • Many marathons will have pace groups that run at a specific speed or pace throughout the race.
  • The pace groups will have runners running a set time so other runners can key off these runners.
  • There are typically set paces for a 3-hour marathon time up to a 6-hour marathon time.
  • Runners can use pacers to help them reach their goals without relying on technology, such as a smartwatch or GPS, to determine if they maintain the correct speed throughout the race.

Distance Pacer

  • Professional and non-professional runners who run long distances or ultramarathons may also use a pace runner to set a specific tempo.
  • Ultramarathons are any race with a distance longer than the standard marathon of 26.2 miles.
  • Because some ultramarathons can be as long as 50 to 100 miles, runners who choose to have a pacer often have several pacers at different sections to motivate them and help set the rhythm.

Record Pacer or Rabbit

  • A record pacer, also known as a rabbit, is a pacer who helps a professional runner set a new record.
  • A rabbit often leads the race for a predetermined distance at a predetermined pace.
  • Some races have multiple pacers at various distances.

How Are Pacers Used?

There are different reasons for having a pacer, but they are based on the runner’s goals.

  • A runner being paced runs directly behind a pacer or pacers.
  • A pacer can run any pace requested, but typically, the pace groups run at an even pace or with a slight negative split.
  • A negative split is when a runner runs the race’s second half faster than the first half.

How Do They Help?

  • A pacer can be helpful because it takes more energy to lead a race than to sit back and follow another runner.
  • The pacer is responsible for timing and establishing the tempo so runners only have to focus on running.
  • A pacer does more work setting the pace, which allows the runner being paced to relax and not stress about hitting the pace.

A study focused on elite athletes who used pacers. It found that running together at a realistic speed helped optimize and achieve finishing time goals. (Casado A. et al., 2021) However, not all elite events allow pacers to participate. Some championship events, like the Olympics and NCAA Championships, do not allow pacer runners.

Benefits

Benefits of running with a pacer.

Prevent Running Too Fast

  • When a race begins, runners can take off and start too fast.
  • Starting too quickly can negatively impact the runners, like losing energy and stamina.
  • A pacer can help start the race with a steady pace, keeping them from going out too fast or expending too much energy.

Maintain an Even Pace

  • Maintaining an even pace can be difficult throughout a long race or a marathon.
  • Having a pacer can relieve some stress and pressure.
  • A pacer can keep the runners on an even pace or negative splits versus going out too fast and losing energy.

Focus on the Race

  • Pacers help the runners stay focused on the race without worrying about how they are running or maintaining the right speed.
  • A pacer can help keep runners relaxed.

Motivating

  • Pacers can help motivate runners.
  • The pace runners may encourage individuals along the way and help them stay motivated to keep working toward their goal, especially when the hard parts come.

Disadvantages

Running with a pacer can sometimes be more stressful than beneficial, especially for amateur runners. A pacer or pace group can be helpful, but it also can create more stress for some amateur runners.

  • Sometimes, individuals realize the pacer is running too quickly for what they can handle.
  • Anxiety can present as not being able to keep up.
  • Other times, runners underestimate their abilities and run more slowly than their bodies can handle.
  • However, runners don’t have to stay with a pace group just because they started with them.
  • Individuals can run ahead.
  • Or if the group is too fast, the runner can slow down and join the slower-paced group behind them.
  • The key is to listen to your body and do what feels right.

Becoming a Pacer

An experienced runner who wants to be a pacer for a race can contact a running organization about becoming a pace runner.

  • Individuals need to be able to have consistent racing times.
  • Be able to run at a set speed for a long duration.
  • Most pacers will contact the race organization to apply for a certain pace.
  • Some pacers enjoy the thrill of running in a race and helping other runners meet their goals.
  • The runner’s goals and the type of event also influence who the pacer is.

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals can talk to local running experts or a running coach. 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. We can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

The Difference of Using Custom Foot Orthotics

References

Casado, A., Hanley, B., Jiménez-Reyes, P., & Renfree, A. (2021). Pacing profiles and tactical behaviors of elite runners. Journal of Sport and Health Science, 10(5), 537–549. https://doi.org/10.1016/j.jshs.2020.06.011

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care , , , , , , , , , , , , , , , , , ,

Center of Gravity Explained: A Comprehensive Guide

What is the body’s center of gravity to understand and maintain a healthy posture and balance?

Center of Gravity

The human center of gravity, or COG, also known as the center of mass, with the two terms being interchangeable, is where the body’s weight appears to be concentrated. It’s a point in space where the entire body’s mass can be concentrated. When standing upright, the COG is generally located behind the navel and in front of the sacrum, around the level of the second vertebra. (Le Huec, J. 2011) The center of gravity is related to posture, including issues such as swayback, the design of posture exercise programs, and much more.

  • Gravity is a downward pull or force the Earth exerts on the body, creating weight. (NASA, 2013)
  • The center of gravity (COG) is where a body’s weight is equally balanced in all directions. (Physiopedia, 2025)
  • When the COG is defined, it is done from the reference of a static, standing position.
  • Because the body is in motion when we change positions, the COG is located in a new position with each new position.
  • The center of gravity is the point around which all the parts balance, which may be inside or outside the body.
  • Even slight changes in position can change where the COG is. (Physiopedia, 2025)

Key aspects of the COG

Location

  • When standing upright, the COG is typically found at the second vertebral level, behind the navel and in front of the sacrum. (Le Huec, J. 2011)

Shifting COG

  • The COG can shift depending on body position, posture, and movements like bending forward or backward. (Physiopedia, 2025)

Balance Impact 

  • The relationship between the COG and the base of support (the area of the body in contact with the ground) is fundamental to maintaining balance.

Variations

  • There can be variations in the COG location based on factors like gender (men tend to have a slightly higher COG), body shape, and even conditions like obesity or chronic low back pain. (Physiopedia, 2025)

Biomechanics

  • Understanding the COG is crucial in biomechanics and movement analysis, as it’s an index of total body motion and how the body responds to external forces.

The Human Center

The center of gravity is the point at which the body’s mass is equally balanced. This point changes depending on one’s position:

  • Arms up/down
  • Leaning
  • Turning

With strength and flexibility training, the human body can change its center of gravity, as gymnasts and dancers do.

  • When standing, the center of gravity is normally located behind the navel and in front of the sacrum bone (made up of five vertebrae fused vertically) at about the second vertebra level. (Hasegawa K. et al., 2022)
  • Because the body has moving parts, its overall shape changes every time it moves. Carrying something like a suitcase or grocery bag or wearing a backpack adds weight to some areas but not others, changing the center of gravity as it does.
  • The center of gravity is a continually changing point inside or outside the body that represents where the weight or mass of the rest of the body is equally balanced in every direction.
  • This point can and does change based on what is being carried and how it is carried, as well as body position and movements.

Chronic Lower Back Pain

  • A study in the Journal of Back and Musculoskeletal Rehabilitation found that individuals with chronic lower back pain tend to have their center of gravity located excessively towards the back. (Kim D. H., Park J. K., & Jeong M. K. 2014)
  • In the study, the individuals had decreased low back strength upon extension and a reduced normal low back curve.
  • The researchers found that those with chronic lower back pain whose center of gravity was too far back may need physical therapy to retrain the body to overcome strength and balance challenges to re-establish and maintain a healthy posture.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Enhance Your Lifestyle Today with Chiropractic Care

References

Le Huec, J. C., Saddiki, R., Franke, J., Rigal, J., & Aunoble, S. (2011). Equilibrium of the human body and the gravity line: the basics. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 20 Suppl 5(Suppl 5), 558–563. https://doi.org/10.1007/s00586-011-1939-7

NASA. Jet Propulsion Laboratory, California Institute of Technology. (2013). What is gravity? Retrieved from https://gracefo.jpl.nasa.gov/news/5/what-is-gravity/

Physiopedia. (2025). Centre of gravity. https://www.physio-pedia.com/Centre_of_Gravity

Hasegawa, K., Amabile, C., Nesme, M., & Dubousset, J. (2022). Gravity center estimation for evaluation of standing whole body compensation using virtual barycentremetry based on biplanar slot-scanning stereoradiography – validation by simultaneous force plate measurement. BMC musculoskeletal disorders, 23(1), 22. https://doi.org/10.1186/s12891-021-04948-5

Kim, D. H., Park, J. K., & Jeong, M. K. (2014). Influences of posterior-located center of gravity on lumbar extension strength, balance, and lumbar lordosis in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation, 27(2), 231–237. https://doi.org/10.3233/BMR-130442

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

Cornstarch: How to Replace Flour in Recipes

How can cornstarch be used instead of flour in recipes for individuals on a gluten-free diet who are looking for a flour alternative due to celiac disease or non-celiac gluten sensitivity?

flour table

Cornstarch Substitute

Flour is often used as a thickener or a coating in recipes. Pure cornstarch (made from corn) is a gluten-free flour substitute (Rai S., Kaur A., & Chopra C.S., 2018). However, some brands are not considered gluten-free.

Substitute for Flour

It’s easy to substitute cornstarch for flour when the recipe calls for a thickener, such as in gravies, sauces, pies, or coatings for fried foods. If flour is unavailable or individuals want to try a gluten-free alternative, cornstarch has a similar effect in these cooking applications.

However, individuals should be aware that it cannot be used as a substitute for flour in baked goods.

As a Thickener

Cornstarch can be a thickener in sauces, gravy, and pie fillings. (Bob’s Red Mill, 2020)

  • There is no taste of cornstarch.
  • However, foods will be more translucent.
  • This is because it is pure starch, while flour contains some protein.
  1. Cornstarch is not a 1:1 substitute for flour.
  2. Individuals should generally use one tablespoon for each 1 1/2 to 2 cups of flour for sauce/gravy for medium thickness. (The Denver Post, 2016)

When using cornstarch as a thickener:

  • Bring the mixture to a full boil for 1 minute, which allows the granules to swell to their maximum.
  • Reduce the heat as it thickens.
  • Overcooking can cause mixtures to thin when cooled.
  • Cook over medium-low to medium heat, as high heat can cause lumping.
  • Stir gently
  • Stirring vigorously can break down the mixture.
  • If more ingredients are needed, remove the pot from the heat and stir them quickly and gently.
  • Avoid freezing sauces or gravies since they won’t freeze well. (Cook’s Info, 2008)

How To Use

  • Use half as much cornstarch as you would flour.
  • For example, if the recipe calls for two tablespoons of flour, use one tablespoon of cornstarch.
  • If the recipe calls for 1/4 cup of flour, use 1/8 cup of cornstarch.
  • This is true for other starches, including arrowroot, potato, and tapioca. (Taste of Home, 2023)
  • Adding the cornstarch directly will cause it to clump and form lumps in the sauce that will be difficult to dissolve.
  • To avoid this, mix the cornstarch with cold water (1 tablespoon of cornstarch to 1 tablespoon of cold water) until it is dissolved.
  • Then pour the water/starch mixture/slurry into the mix.
  • Keep stirring as the mixture thickens. (Bon Appetit, 2020)

Cornstarch is not as effective as flour when thickening acidic sauces. It doesn’t work well with tomato, vinegar, or lemon juice sauces. It is also less effective than flour when thickening sauces made with fat, including butter or egg yolks. (The BC Cook Articulation Committee, 2015)

If the mixture contains too little liquid, the starch granules cannot absorb. This is also the case when there is more sugar than liquid, in which case, more liquid is needed to firm up the mixture.

Fried Dishes

Individuals can use cornstarch instead of flour to coat fried chicken, fish, or other fried dishes. It creates a crisper coating that better withstands sauces and absorbs less frying oil, resulting in a lower-fat meal. Tips for frying:

  • Try a 50/50 blend of cornstarch and gluten-free flour for a coating closer to wheat flour. (Bon Appetit, 2016)
  • Ensure there is a light, even cornstarch coating on the food.
  • Heavier coatings can get gummy.

Injury Medical Chiropractic and Functional Medicine Clinic

When cooking gluten-free, individuals may be able to continue to enjoy some of their favorite sauces by learning how to use cornstarch and other gluten-free thickeners instead of flour. As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. 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.

From Consultation to Transformation: Assessing Patients in a Chiropractic Setting

References

Rai, S., Kaur, A., & Chopra, C. S. (2018). Gluten-Free Products for Celiac-Susceptible People. Frontiers in Nutrition, 5, 116. https://doi.org/10.3389/fnut.2018.00116

Bob’s Red Mill. (2020). Baking with cornstarch: Everything you need to know. https://www.bobsredmill.com/articles/baking-with-cornstarch-everything-you-need-to-know

Denver Post. (2016). Cornstarch a good way to thicken gravy lightly. https://www.denverpost.com/2010/11/20/cornstarch-a-good-way-to-thicken-gravy-lightly/

Cook’s Info. (2008). Thickeners. https://www.cooksinfo.com/thickeners/

Taste of Home. (2023). Cornstarch vs. flour vs. arrowroot – when should you use which thickener? https://www.tasteofhome.com/article/best-thickener/

Bon Appetit. (2020). Cornstarch is a powerful tool that must be used responsibly. https://www.bonappetit.com/story/the-power-of-almighty-cornstarch

The BC Cook Articulation Committee. (2015). Understanding Ingredients for the Canadian Baker
Types of thickening agents. https://opentextbc.ca/ingredients/chapter/types-of-thickening-agents/

Bon Appetit. (2016). 4 brilliant ways to cook with cornstarch. https://www.bonappetit.com/story/cornstarch-uses-sauce-crispy-meat

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, Sleep Hygiene , , , , , , , , , , , , , , , , ,

Pseudoarthrosis After Spinal Fusion Surgery Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis of the cervical and lumbar spine

Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:

  • Issues with the instruments used to stabilize the bone
  • Lack of bone growth
  • The number of vertebrae being fused.

The patient’s health and lifestyle play a role in failed fusions, which can include

  • Diabetes
  • Inflammatory health conditions increase the risk
  • Smoking
  • Long-term steroid use

In many cases, revision surgery is needed.

Surgery-Related

During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:

  • Plates
  • Rods
  • Screws
  1. The bone graft promotes growth between the two bones.
  2. The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
  3. The hardware goes inside, or internal fixation.
  4. Although rare, a severe spinal fracture or deformity may need external fixation.
  5. A rigid frame secured outside the body helps to stabilize the bones.

If the fusion fails, it could be caused by one or more of the following surgical issues:

Number of Vertebrae Being Fused

Hardware

  • The surgeon must carefully plan and use the right hardware.
  • The type of hardware used during a spinal fusion may influence bone healing.
  • The instruments can come loose or break, interfering with the fusion process.
  • Spinal osteoporosis, having thin, weak bones, can affect fixation.
  • Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.

Bone Graft

  • The type of bone graft used may affect the fusion.
  • For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
  • Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
  • The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.

Risk Factors

  • The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
  • Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)

The risk of pseudoarthrosis increases if the individual has any of the following: (Scoliosis Research Society, 2023)

  • Previous pseudoarthrosis
  • Obesity
  • Chronic steroid use
  • Malnutrition
  • Inflammatory diseases

Inflammatory conditions that can lead to bone loss and non-optimal bone healing include: (Torres H. M. et al., 2023)

  • Diabetes (Jiao H, Xiao E, & Graves DT, 2015)
  • Inflammatory bowel disease
  • Psoriasis
  • Rheumatoid arthritis
  • Chronic obstructive pulmonary disease/COPD
  • Periodontitis
  • Systemic lupus erythematosus/SLE

Symptoms

  • The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
  • If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
  • Rarely does a pinched nerve affect both arms.
  • The pain may return shortly after the procedure.
  • The pain may develop gradually or not appear for many months.
  • However, it’s more likely to appear after several months when the individual returns to their usual activities.

Diagnosis

  • The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
  • They’ll assess mobility and the type of movement that causes pain.
  • Then, they order diagnostic imaging to see the spine and identify the cause of pain.
  • Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.

Treatment

Treatment for pseudoarthrosis will likely start with:

  • Physical therapy
  • Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
  • Medication
  • Injections
  • If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
  • Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Enhancing Health Together

References

Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. https://doi.org/10.1186/s12891-024-07531-w

Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. https://doi.org/10.1055/s-0041-1722853

Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. https://doi.org/10.14444/4029

Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. https://doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1

Scoliosis Research Society. (2023). Pseudoarthrosis. https://www.srs.org/Patients/Conditions/Pseudoarthrosis

Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. https://doi.org/10.1007/s11914-023-00824-4

Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. https://doi.org/10.1007/s11914-015-0286-8

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

Length of Time for Muscle Tightness Relief

For individuals dealing with or experiencing muscle pain and stiffness, how long does it take to loosen tight muscles?

Length Of Time to Loosen Tight Muscles

Tight muscles are often caused by overuse or strain, combined with muscle soreness, a common symptom of tight muscles. The soreness peaks around the third day and begins to subside, typically resolving within a few days. But if tightness persists or is accompanied by other symptoms like numbness, inability to move, or swelling, it’s important to consult a medical provider. (Spine Medicine and Surgery of Long Island, 2024) However, it can take much longer for individuals who have never stretched and have had tight muscles for years, depending on the severity, injury history, and underlying causes.

Factors Influencing Timeline

Consistent stretching can take anywhere from a few weeks to a few months to noticeably loosen tight muscles and improve flexibility. The specific time frame depends on factors like the severity of the tightness, underlying causes, and individual consistency with stretching. (Peterson Physical Therapy, 2024)

Severity of Tightness

  • Muscle knots and significant limitations in range of motion may take longer to resolve than minor stiffness.

Underlying Causes

  • If tightness is due to a specific injury or condition, addressing that cause is important for lasting and maintaining improvements. (Healthline, 2023)

Individual Factors

  • Genetics, age, and overall health can influence how quickly muscles adapt to stretching.

Consistency

  • Regular stretching, ideally daily or several times a week, is essential for feeling progress. (Mayo Clinic, 2023)

Stretching Routine

The length of time can vary based on the starting flexibility level and the specific stretching routine. (Mayo Clinic, 2023) It typically takes several weeks of consistent stretching, at least 3-4 times a week, to notice flexibility improvements. Longer-term changes, beyond the initial feeling of being looser, usually take 8 to 12 weeks.

Consistency

Hold Time

  • Hold static stretches for at least 30 seconds.
  • Longer holds (1-2 minutes) can provide deeper benefits.

Long-term Gains

  • For substantial and sustained improvements, stretching consistently for several months is recommended. (Mayo Clinic, 2023)

Initial Changes

  • Individuals may notice small improvements in the first few weeks, especially starting from a more inflexible position.

Influencing Factors and Results

  • Individual genetics, current flexibility level, and the specific exercises can affect how quickly improvements are seen and felt. (Peterson Physical Therapy, 2024)

What To Expect

Improvements

  • Within a few weeks, individuals might notice a decrease in the sensation of tightness or increased ease in reaching a stretch. (Peterson Physical Therapy, 2024)

Longer-Term Changes

  • Significant muscle length and flexibility improvements may take several weeks to months of consistent effort.

Maintenance

Treatment Options

  • Stretching, physical therapy, massage, and other therapies can help alleviate tight muscles and promote recovery. (Spine Medicine and Surgery of Long Island, 2024)
  • Consider professional guidance for specific concerns or limitations. Consult a physical therapist or healthcare provider for personalized recommendations.

The length of time to see results means consistency and patience are important.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Understanding Long-Lasting Injuries

References

Spine Medicine and Surgery of Long Island. (2024). How Long Do Muscle Knots Last? Spine Medicine and Surgery of Long Island. https://www.spinemedli.com/how-long-do-muscle-knots-last/#:~:text=The%20duration%20of%20a%20muscle,chronic%20pain%20if%20left%20untreated.

Peterson Physical Therapy. (2024). How Long Does It Take to Improve Flexibility? https://petersenpt.com/how-long-does-it-take-to-improve-flexibility#:~:text=Over%20the%20years%2C%20I’ve,takes%20to%20become%20more%20flexible.

Healthline. (2023). Everything You Need to Know About Muscle Stiffness. https://www.healthline.com/health/muscle-stiffness

Mayo Clinic. (2023). Stretching: Focus On Flexibility. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931#:~:text=Stretch%20in%20a%20smooth%20movement,hold%20for%20around%2060%20seconds.

Harvard Health Publishing. (2022). Everyday Stretching. https://www.health.harvard.edu/everyday-stretching#:~:text=A%20daily%20regimen%20will%20deliver,or%20three%20times%20a%20week.

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

Pilates Nutrition for Enhanced Performance and Recovery

Many ask, what and when should you eat before, during, and after engaging in Pilates exercises?

Pilates Nutrition Plan

Pilates involves a lot of core work on the mat. However, it does not require a special diet. To fully utilize Pilates nutrition, individuals should consider what foods keep their bodies feeling the most balanced. A balanced nutrition plan can enhance Pilates practice by:

  • Providing sustained energy
  • Supporting muscle recovery
  • Promoting overall well-being

Pre-Pilates

Timing

  • Eat a light meal or snack 2-3 hours before a class or a smaller snack 30 minutes before.

Food Options

  • Eat complex carbohydrates like whole grains, fruits, and vegetables for sustained energy.

Avoid

  • Heavy, greasy, or spicy foods may cause discomfort during exercise.
  • Foods that will make you gassy or cause queasiness.

During the Workout

Complex carbohydrates and lean proteins, with a little healthy fat, are good pre-Pilates meals, as they sustain energy better than simple carbs or sugary snacks. (American Heart Association, 2024) Suggestions for a pre-Pilates meal.

  • Individuals can adjust the portion size.
  • A protein shake that uses fruit can be convenient.
  • Peanut butter on whole-grain bread offers a quick source of complex carbohydrates and protein.
  • Yogurt with fruit.
  • Small portion of oatmeal.

Because Pilates emphasizes using the abdominal muscles, individuals will want to ensure that any food they’ve eaten before their session is fully digested. Try to eat light before, like snacking on a banana or sipping on a smoothie for some carbohydrates for energy. Regardless of what is eaten, nutrition experts recommend waiting two to three hours after eating before exercising.

Maintain Hydration

  • Drink water and/or eat hydrating fruits throughout the day, especially before and during the workout or class.

After Working Out

Individuals want to ensure their bodies have enough nutrients to strengthen their muscles and replenish their energy. Try a protein green smoothie afterward or a light snack with lean protein like fish or chicken and carbohydrates like whole grains. The diet between workouts will depend on weight loss goals.

Timing

  • Consume a protein-rich snack or meal within 30-60 minutes after your class to aid muscle recovery.

Food Choices

  • Focus on protein for muscle repair and carbohydrates to replenish energy stores.

Hydration

  • Continue to hydrate to replenish fluids lost through perspiration.

While Pilates can complement cardiovascular exercise as part of a fat-burning workout program, health experts advise that losing weight will not come from exercise alone. Individuals will need to work on reducing their calorie intake overall. (Centers for Disease Control and Prevention, 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions.

  • Wellness & Nutrition: Personalized plans to optimize health and prevent disease.
  • Sports Injuries & Orthopedic Care: Treatment for sprains, strains, and complex injuries.
  • Chronic Pain Management: Non-invasive solutions for fibromyalgia, sciatica, and low back pain.
  • Personal Injury & Auto Accident Care: Tailored rehabilitation for whiplash, soft tissue injuries, and more.
  • Functional Medicine: Root-cause analysis for chronic disorders, incorporating nutrition, lifestyle, and environmental factors.
  • Neuromusculoskeletal Health: Care for neck pain, migraines, herniated discs, and scoliosis.

Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Home Exercises for Pain Relief

References

American Heart Association. (2024). Food as fuel before, during, and after workouts. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/food-as-fuel-before-during-and-after-workouts

Centers for Disease Control and Prevention. (2023). Tips for Maintaining Healthy Weight. Retrieved from https://www.cdc.gov/healthy-weight-growth/about/tips-for-balancing-food-activity.html?CDC_AAref_Val=https://www.cdc.gov/healthyweight/calories/index.html

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

Supine Position Explained: Benefits and Uses

For individuals experiencing back pain, can lying in the supine position help bring relief?

Supine Position

The supine position describes the body’s position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It’s commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)

Medical Uses

Examinations

  • Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)

Procedures

Surgery

  • Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures. 
  • It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)

Overall Health

Natural Position

  • Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.

Back Pain Relief

  • Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)

Acid Reflux

  • However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)

Sleep Apnea

  • The supine position can worsen sleep apnea in some individuals.

Clinical Uses

  • A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
  • If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
  • This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
  • Many bed exercises begin in this position for rehabilitation.

Back Care

Here are a few recommendations to relieve low back pain using the supine position.

  • First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
  • Start breathing and relaxing, allowing the tension to drain out of the muscles.
  • In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
  • At that point, the fingertips should feel the transverse abdominal muscle engage.
  • Release and repeat 10 times.

After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.

For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.

Variations

Lawn Chair Position

  • This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.

Frog-Leg Position

  • The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 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.

Thoracic Spine Pain

References

ScienceDirect. (2009). Supine Position. Morrey’s The Elbow and Its Disorders (Fourth Edition), 567-577. https://doi.org/https://doi.org/10.1016/B978-1-4160-2902-1.50042-5

Nurse.com. (2024). What Is Supine Position? https://www.nurse.com/nursing-resources/definitions/what-is-supine-position/#:~:text=During%20routine%20physical%20examinations%2C%20the,easier%20to%20perform%20comprehensive%20assessments.

STERIS. (2025). The Complete Guide to Patient Positioning. https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning#:~:text=The%20most%20common%20position%20used,and%20elevating%20the%20sternal%20notch.

MedicalNewsToday. (2022). What is the supine position? https://www.medicalnewstoday.com/articles/supine-position

Aurora BayCare Medical Center. (N.D.). Lumbar stabilization hooklying position. https://ahc.aurorahealthcare.org/fywb/baycare/x06913bc.pdf