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Cobb Angle: From Measurement to Treatment Decisions

The Cobb angle is a mathematical measurement tool for assessing the curvature of the spine. Along with physical exams and other tests, how is it used to evaluate scoliosis and kyphosis of the spine?

Cobb Angle

The Cobb angle is used to quantify the curvature of the spine, particularly in conditions like scoliosis. It measures the degree of side-to-side spinal curvature, a deformity called scoliosis. The angle’s size helps determine what kind of treatment is needed. Monitoring may be all that’s necessary for mild curvature. With severe scoliosis, treatment may require spinal fusion surgery. Named for orthopedic surgery pioneer John Robert Cobb, it describes the distance a scoliotic curve may deviate from being straight. (Botterbush K. S. et al., 2023) Generally, it takes at least 10 degrees of deviation from straight before scoliosis is confirmed.

X-Ray and Interpretation

An X-ray is taken to measure the Cobb angle. Side and back views are taken. The healthcare provider or examiner then views the X-rays and locates the most affected vertebra in the curve, called the apical vertebra. In a scoliotic curve, the apical vertebra is the spinal bone with the greatest degree of rotation that takes the biggest curve away from the center of a normal spine column.

Visualizing the Angle

The apical vertebra is where two lines drawn from the X-rays meet. Two lines are drawn along the edge of the top and bottom bones of the curve. The lines extend out as follows:

  • On the top bone, the line starts on the high side, continues along the top edge, and then slopes down according to the angle of the vertebra. (Jin, C. et al., 2022)
  • On the bottom vertebra, the line starts on the low side, continues along the bottom edge, and slopes upward.
  • The Cobb angle is found by measuring the angle of the two intersecting lines where they meet.

Then, the top and bottom vertebrae of the side-to-side curve are identified to create a number for the Cobb angle. These bones have the most tilt but the least rotation and displacement and are located above and below the apical vertebra. Computer software is commonly used to calculate the Cobb angle. (Jin, C. et al., 2022) Treatment is based on the:

10 Degrees Cobb Angle 

Scoliosis is diagnosed when the Cobb angle reaches 10 degrees or more. However, this is not generally considered a significant curvature (American Association of Neurological Surgeons, 2024). In around 80% of cases, the scoliosis is considered idiopathic or without congenital or other underlying causes.

Less Than 25 Degrees Cobb Angle

If a scoliotic curve is less than 25 degrees, individuals may only need to visit their healthcare provider periodically so long as the scoliosis is monitored. These are mild cases, often without symptoms, but there is a chance that the curvature can progress. This usually means reassessing the Cobb angle every four to six months in a growing child or adolescent. (National Scoliosis Foundation, 2015) A 5-degree or more progression can change the diagnosis and treatment. (Jin, C. et al., 2022)

Between 25 and 40 Degrees Cobb Angle

A Cobb angle of 25 to 40 degrees usually requires wearing a back brace and intensive physical therapy. The goal of these treatments is to help halt the curve’s progression. Braces are generally worn 16 to 23 hours every day. (National Scoliosis Foundation, 2015) The healthcare provider will provide a referral for physical therapy. Many report excellent results with the Schroth or other scoliosis-specific exercise methods. A study found that core stabilization exercise programs can decrease Cobb angles in adolescents with idiopathic scoliosis. (Ko K. J. & Kang S. J. 2017)

Scoliosis in Adults

Scoliosis is diagnosed in adults, usually in those who have had the condition, treated or not, that was identified in their youth. A study that followed various cases for 20 years found disease progression occurred in 40% of adults but was usually less than one degree per year. However, degenerative scoliosis can also occur in individuals aged 65 and older. (American Association of Neurological Surgeons, 2024)

40 Degrees or More Cobb Angle

Surgery may be recommended once the Cobb angle reaches 40 to 50 degrees. A spinal fusion is often used to force the curve to stop developing. In adults, surgery may be needed if the angle reaches 50 degrees and they experience complications, such as nerve damage or bowel/bladder dysfunction. Risk factors in adults include older age, a history of smoking, and a diagnosis of other conditions, including being overweight. (American Association of Neurological Surgeons, 2024)

Variations

Variations occur in measuring scoliosis, and it is important to understand the difference between a change in scoliosis and a change in the tools or measurement. Equipment errors, imaging errors, and the subjective reading of the healthcare provider can change the values. (Jin, C. et al., 2022) Scoliosis measurement software and intelligent medical devices continue to improve how scoliosis is evaluated and treated. Physical exams, symptoms, and careful monitoring of changes in posture or function are still critical to an accurate diagnosis. The healthcare provider will explain the Cobb angle and other test results.

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.


Academic Low Back Pain: Impact and Chiropractic Solutions


References

Botterbush, K. S., Zhang, J. K., Chimakurty, P. S., Mercier, P., & Mattei, T. A. (2023). The life and legacy of John Robert Cobb: the man behind the angle. Journal of neurosurgery. Spine, 39(6), 839–846. https://doi.org/10.3171/2023.7.SPINE23146

Jin, C., Wang, S., Yang, G., Li, E., & Liang, Z. (2022). A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel, Switzerland), 22(9), 3258. https://doi.org/10.3390/s22093258

National Scoliosis Foundation. (2015). Scoliosis Media & Community Guide. https://www.scoliosis.org/nsf2/wp-content/uploads/2015/06/ScoliMediaGuide_9June3.pdf

American Association of Neurological Surgeons. (2024). Scoliosis. https://www.aans.org/patients/conditions-treatments/scoliosis/

Ko, K. J., & Kang, S. J. (2017). Effects of 12-week core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescents with idiopathic scoliosis. Journal of Exercise Rehabilitation, 13(2), 244–249. https://doi.org/10.12965/jer.1734952.476

Abdominal Self Massage Techniques for Constipation

For individuals struggling with constipation, a common digestive issue, could performing abdominal self-massage help bring relief?

Abdominal Self Massage

Constipation refers to having a bowel movement fewer than three times per week. In addition to stress, certain lifestyle issues can lead to constipation, including not getting enough fiber, exercise, and proper hydration. Many also experience constipation while traveling. Abdominal self-massage involves gently massaging the stomach with your hands, either in a circular motion or with strokes, to improve digestion, relieve constipation, and reduce bloating. Performing self-massage on and around the abdomen can help ease constipation in several ways, such as stimulating the muscles, producing bowel movements, and soothing chronic stress. (Sinclair M. 2011)

Massage and Constipation

Abdominal massage can provide several benefits, including:

Stimulates and Improves Digestion

  • Massage stimulates the muscles and nerves that control digestion, promoting bowel movements and reducing constipation.

Reduces Bloating

  • Massaging the abdomen may help to reduce bloating and gas by gently moving fluids and gases through the digestive system.
  • In addition, it can help soften stool, speed up the movement of stool through the gut, and reduce the need to use laxatives. (University of Michigan Medicine, 2021)

Relieves Constipation

  • Abdominal massage can help with constipation by encouraging bowel movements.

Reduces Pain and Discomfort

  • Some find that abdominal massage helps to reduce pain and discomfort related to digestive issues.
  • Massage can help relax tense abdominal muscles and reduce pain associated with conditions like irritable bowel syndrome (IBS).

Improved lymphatic drainage

  • Massage helps move lymphatic fluid, which carries waste products and toxins away from the abdominal area.

Research

Although massage isn’t a standard treatment for constipation, some research shows it may help restore regularity. A report reviewed several clinical trials focusing on abdominal massage and its use as a treatment for chronic constipation. The results showed that abdominal massage may provide relief by promoting peristalsis, a series of muscle contractions that help move food through the digestive tract.  The report also found that massage may help lessen colonic transit time, which is when digested food passes through the colon or last segment of the digestive tract. The report determined that abdominal massage can help alleviate constipation-related pain and discomfort. (Sinclair M. 2011)

In clinical trials, individuals with constipation reported improved quality of life after abdominal self-massage. However, some research suggests that using abdominal massage for constipation relief will not decrease the use of laxatives, the most commonly used treatment. (Lämås K. et al., 2009)

How to Massage

Various massage techniques may help relieve constipation and promote bowel movements. These are typically performed while lying down.

  • One technique involves placing the palm on the abdomen and making small, circular, clockwise motions around your belly button.
  • Individuals can also widen these circles so that the massage covers their entire abdomen.
  • Another technique begins by placing your hand below your breastbone, then gliding that hand down the length of your abdomen in one smooth stroke.
  • Repeat the movement with the other hand and continue this cycle for a few minutes.
  • When practicing self-massage, use light and gentle pressure, then gradually increase the pressure.
  • If you experience pain or tenderness, lighten up and return to a comfortable pressure level.

Try performing massage twice daily, aiming for a 20-minute session. Incorporating deep breathing into each session may also help. Before trying a massage or any home remedy, it is recommended to discuss it with a healthcare provider to see if it’s appropriate and safe. Pregnant women, for example, should avoid any massage on their abdomen. Constipation can sometimes signal an underlying condition that requires medical treatment, such as an underactive thyroid. Other symptoms like abdominal pain may be present, but sometimes constipation may be the only symptom.

Other Remedies

Self-massage alone is unlikely to treat chronic constipation; the goal should be to improve overall digestion to keep the organs functioning properly. To maintain regularity, it’s essential to drink plenty of water daily, eat enough fiber-rich foods, and engage in physical activity. Other alternative treatments include therapies like:

  • Acupressure
  • Biofeedback
  • Probiotics

Before trying self-massage, consult a medical caregiver to ensure it is safe and correct for the individual. Abdominal massage may not help with painful bloating caused by disease, infection, or other reasons.

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.


Massage Therapy Rehabilitation


References

Sinclair M. (2011). The use of abdominal massage to treat chronic constipation. Journal of bodywork and movement therapies, 15(4), 436–445. https://doi.org/10.1016/j.jbmt.2010.07.007

University of Michigan Medicine. (2021). Self-abdominal massage. https://www.med.umich.edu/1libr/MBCP/AbdominalSelfmassage.pdf

Lämås, K., Lindholm, L., Stenlund, H., Engström, B., & Jacobsson, C. (2009). Effects of abdominal massage in management of constipation–a randomized controlled trial. International journal of nursing studies, 46(6), 759–767. https://doi.org/10.1016/j.ijnurstu.2009.01.007

Complex Regional Pain Syndrome: A Patient’s Guide

Individuals dealing with chronic pain following a minor injury, surgery, or trauma could be experiencing complex regional pain syndrome. What are the symptoms, diagnosis, and treatments available?

Complex Regional Pain Syndrome

Reflex sympathetic dystrophy syndrome (RSDS), more commonly known as complex regional pain syndrome (CRPS), is a chronic pain condition where a person experiences severe, persistent pain in a limb, usually following an injury, that is significantly more profound than from the initial trauma. It is considered a neuroinflammatory disorder in which the body’s response to injury is dysregulated. The condition is characterized by severe burning pain, often in an arm or leg, that can occur following a minor injury, surgery, or trauma. It is associated with abnormal changes in skin temperature, swelling, and sensitivity to touch, usually affecting the affected area’s nerves, skin, muscles, blood vessels, and bones. Other names it is known by include:

  • Causalgia
  • Shoulder-Hand Syndrome
  • Sudeck’s Atrophy

Causes

CRPS is a chronic pain condition believed to result from dysfunction in the central or peripheral nervous systems (National Institute of Neurological Disorders and Stroke, 2017). It involves irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin. Animal studies indicate that norepinephrine, a catecholamine released from sympathetic nerves, acquires the ability to activate pain pathways after tissue or nerve injury, resulting in CRPS. Another theory is that CRPS, which follows an injury, is caused by triggering an immune response and continuous inflammation symptoms (swelling, redness, warmth). (Goh E. L., Chidambaram S., & Ma, D. 2017) It is believed to have multiple causes producing similar symptoms.

Triggers

There can be numerous triggers, including:

Symptoms

CRPS usually affects one of the extremities (arm, leg, hand, or foot). The primary symptom is intense, continuous pain. (National Institute of Neurological Disorders and Stroke, 2017) Other symptoms can include

  • Burning pain
  • Swelling
  • Increased skin sensitivity
  • Extreme sensitivity to touch, often causing significant disability in the affected limb.
  • Stiffness and swelling in affected joints
  • Skin color changes – blotchy, purple, pale, red.
  • Skin temperature changes – warmer or cooler than the opposing extremity.
  • Skin texture changes – shiny, thin, sweaty.
  • Changes in nail and hair growth patterns.
  • Pain can spread, for example, from the finger to the entire arm and the opposite extremity or from the left to the right arm.
  • Emotional stress can cause symptoms to worsen.

Some experts suggest three stages during which progressive changes occur in the affected area’s skin, muscles, joints, ligaments, and bones (Harvard Health Publishing, 2023). However, further research is needed.

Stages

Stage One

  • Lasts 1 to 3 months
  • Severe, burning pain
  • Muscle spasm
  • Joint stiffness
  • Rapid hair growth
  • Skin color and temperature changes (Stanford Medicine, 2025)

Stage Two

  • Lasts from 3 to 6 months
  • Pain becomes more intense
  • Swelling
  • Decreased hair growth
  • Nails are cracked, brittle, grooved, spotty
  • Softened bones
  • Stiff joints
  • Weak muscle tone

Stage Three

  • Pain is continuous
  • Muscle atrophy
  • Severely limited mobility
  • Irreversible changes to skin and bone
  • Contractions of muscles and tendons – limbs may be twisted

Diagnosis

  • A patient’s clinical history – signs and symptoms are the major factor in diagnosis.
  • The diagnosis is difficult because many symptoms overlap with other conditions. (Goh E. L., Chidambaram S., & Ma, D. 2017)
  • There is no specific blood test or other diagnostic tests.
  • X-rays may show osteoporosis, and nuclear bone scans may show characteristic uptake patterns that help diagnose.

Treatments

Treatment focuses on relieving painful symptoms and can include: (Goh E. L., Chidambaram S., & Ma, D. 2017)

  • Physical therapy and exercise
  • Psychotherapy to alleviate stress, anxiety, and depression
  • Sympathetic nerve blocks
  • Surgery
  • Spinal cord stimulation
  • Intrathecal drug pumps

Medications

These can include:

  • Topical analgesics
  • Anti-seizure drugs
  • Antidepressants
  • Corticosteroids
  • Opioids

It is estimated that there are 50,000 new cases every year in the United States. (Tajerian M., & Clark J. D. 2016)

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.


The Root Causes of Pain


References

National Institute of Neurological Disorders and Stroke. (2017). Complex regional pain syndrome fact sheet. Retrieved from https://www.ninds.nih.gov/sites/default/files/migrate-documents/CRPS_FactSheet-E_508C.pdf

Goh, E. L., Chidambaram, S., & Ma, D. (2017). Complex regional pain syndrome: a recent update. Burns & Trauma, 5, 2. https://doi.org/10.1186/s41038-016-0066-4

Bruehl S. (2015). Complex regional pain syndrome. BMJ (Clinical research ed.), 351, h2730. https://doi.org/10.1136/bmj.h2730

Harvard Health Publishing. (2023). Complex Regional Pain Syndrome (CRPS). https://www.health.harvard.edu/a_to_z/complex-regional-pain-syndrome-crps-a-to-z

Stanford Medicine. (2025). Complex Regional Pain Syndrome (CRPS). https://med.stanford.edu/pain/about/chronic-pain/crps.html

Tajerian, M., & Clark, J. D. (2016). New Concepts in Complex Regional Pain Syndrome. Hand Clinics, 32(1), 41–49. https://doi.org/10.1016/j.hcl.2015.08.003

Nutritional Yeast for Healthy Cooking and Nutrition

Can incorporating nutritional yeast be an option for individuals seeking a healthy vegan and vegetarian cheese substitute?

Nutritional Yeast

Nutritional yeast is a deactivated form of Saccharomyces cerevisiae yeast, commonly known as baker’s or brewer’s yeast. It’s popular in vegan and vegetarian cooking for its savory, cheesy flavor and nutritional benefits. Nutritional yeast is harvested, rinsed, and heat-dried to deactivate it, removing its leavening properties. This means it doesn’t cause food to rise but adds flavor and vital nutrients.

Nutrition

Nutritional yeast nutrition information is for 16 grams or around 1.5 tablespoons. (U.S. Department of Agriculture, 2019)

  • Calories – 60
  • Fat – 0.5 grams
  • Sodium – 30 milligrams
  • Carbohydrates – 5 grams
  • Fiber – 3 grams
  • Sugars – 0 grams
  • Protein – 8 grams
  • Thiamin – vitamin B1 – 10 milligrams
  • Riboflavin – vitamin B2 – 10 milligrams
  • Vitamin B6 – 12 milligrams
  • Vitamin B12 – 24 micrograms

Carbohydrates

  • Around 1.5 tablespoons contains 5 grams of carbohydrates, including 3 grams of fiber.
  • Yeast provides an especially beneficial form of soluble fiber known as beta-glucan, with unique health benefits. (Bashir K. M. I., & Choi J. S. 2017)

Fats

  • Most brands are naturally fat-free.

Protein

  • It provides all essential amino acids with 8 grams per 1.5 tablespoons.

Vitamins and Minerals

Most nutritional yeast products are fortified with added B vitamins. Most provide 600% or more B vitamins per 16 grams and 1,000% of the daily value for vitamin B12, depending on the brand. It also has:

  • Calcium
  • Thiamin
  • Iron
  • Potassium

Nutritional Yeast Health Benefits

Health benefits include:

Reduces Risk of Anemia

Iron is typically the first nutrient to come to mind. However, inadequate folate or vitamin B12 also causes anemia. A common treatment for a vitamin B12 deficiency is injections, but large doses consumed can also be effective. (National Institutes of Health, Office of Dietary Supplements, 2024) Individuals who follow a plant-based or vegan diet often have limited sources of vitamin B12. Most brands of nutritional yeast are fortified with B12, providing more than 500% of the daily value per serving. Because B12 is water-soluble, it won’t cause toxicity when consumed in high doses and can serve as a key source of this essential nutrient.

Supports Heart Health

Nutritional yeast contains beta-glucan, a carbohydrate found in the cell walls of plants, bacteria, and fungi. Higher intakes lead to favorable cardiovascular outcomes, including lowering bad cholesterol and increasing good cholesterol. (Bashir K. M. I., & Choi J. S. 2017) In addition, most brands contain potassium, which reduces blood pressure.

Promote Healthy Immune System Function

More research is needed, but several studies have shown how yeast-derived beta-glucan can strengthen the immune system. (Stier H., Ebbeskotte V., & Gruenwald J. 2014) These benefits are attributed to beta glucan’s bacterial fermentation in the intestines. Beta-glucan may also stimulate the activity of crucial immune system cells, like macrophages.

Prevents Constipation

Fiber is essential. The recommended fiber intake is at least 25 to 35 grams daily. Unfortunately, many do not get enough. Nutritional yeast contributes 3 grams of fiber per 16 grams. Fiber regulates bowel movements by pulling water into the colon and adding bulk and softness to stool. (University of Michigan, 2008)
Using nutritional yeast can help reach an adequate fiber intake.

Diabetes Management

Getting enough fiber helps prevent blood sugar fluctuations. Low-fiber diets have been shown to increase the risk of diabetes in various populations. (Harvard T.H. Chan, School of Public Health, 2022) Fiber slows digestion and increases satiety, controlling hunger and the glycemic response. Fiber is beneficial for preventing diabetes and helping those with diabetes maintain good numbers.

Allergies

  • Individuals who suspect a yeast or mold allergy see an allergist for a full evaluation.
  • Yeast overgrowth is another possible condition that is unrelated to yeast allergies.
  • Yeast overgrowth can occur in compromised immune systems or following antibiotic treatment.
  • Because yeast is present in many foods, anyone with a true yeast allergy may have to avoid several food items, including baked goods, fermented alcoholic beverages, marmite/vegemite, sourdough bread, and certain multivitamins. (Cunningham E. 2013)

Adverse Effects

Nutritional yeast is inactive and unlikely to cause negative effects. However, for individuals who suffer from irritable bowel syndrome (IBS) or migraines, yeast may be a trigger. (UMass Medical School Center for Applied Nutrition, 2020)

Varieties

  • Nutritional yeast may be sold as granules, powder, or flakes. (UMass Medical School Center for Applied Nutrition, 2020)
  • Check the label to see if the product is fortified with added vitamins and minerals or has added sodium.
  • Nutritional yeast is a dry food product available year-round in supermarkets or sold in a bulk food bin.

Storage, Safety, and Use

Although nutritional yeast is a dry product, it will stay in the refrigerator longer after it has been opened. Store it in an airtight container, and be mindful of the expiration date on the label.

It can be added to savory dishes such as pasta, roasted meats, vegetables, and salads. Ways to use include:

  • On scrambled eggs.
  • On top of garlic bread.
  • Popcorn seasoning.
  • Add to soups.
  • In pasta dishes, as a substitute for parmesan cheese.
  • An alternative to cheese sauce.

Injury Medical Chiropractic and 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.


Learning About Food Substitutions


References

U.S. Department of Agriculture. FoodData Central. (2019). Nutritional yeast. Retrieved from https://fdc.nal.usda.gov/food-details/1744022/nutrients

Bashir, K. M. I., & Choi, J. S. (2017). Clinical and Physiological Perspectives of β-Glucans: The Past, Present, and Future. International journal of molecular sciences, 18(9), 1906. https://doi.org/10.3390/ijms18091906

National Institutes of Health, Office of Dietary Supplements. (2024). Vitamin B12: Fact sheet for health professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

Stier, H., Ebbeskotte, V., & Gruenwald, J. (2014). Immune-modulatory effects of dietary Yeast Beta-1,3/1,6-D-glucan. Nutrition journal, 13, 38. https://doi.org/10.1186/1475-2891-13-38

University of Michigan. (2008). Bowel function anatomy. https://medicine.umich.edu/sites/default/files/content/downloads/bowel-function.pdf

Harvard T.H. Chan, School of Public Health. (2022). Fiber. https://nutritionsource.hsph.harvard.edu/carbohydrates/fiber/

Cunningham E. (2013). Is there a diet for “yeast allergy”? Journal of the Academy of Nutrition and Dietetics, 113(3), 484. https://doi.org/10.1016/j.jand.2013.01.013

UMass Medical School Center for Applied Nutrition. Chan, U., School, M., & Nutrition, C. F. A. (2020). Nutritional yeast: Nourishing or no-go? UM. https://www.umassmed.edu/nutrition/blog/blog-posts/2020/2/nutritional-yeast–nourishing-or-no-go/

Greenstick Fracture Explained: A Complete Guide

Broken bones are common injuries. Because children’s bones grow rapidly, they have increased flexibility. When injuries, specifically fractures, occur, they do not always break cleanly across the bone or into pieces. What type of fracture is this, and how are they treated?

Greenstick Fracture

A greenstick fracture is a partial break in a bone that occurs when a bone bends and cracks instead of breaking into separate pieces. (Wolfe J. A. et al., 2019) The term is based on a young green branch that bends and splinters but does not break into pieces when bent. Only one side of the bone is broken, while the other side gets bent. Many children experience at least one fracture during their growing years. This is one of multiple fracture types seen in children. They can happen in adults but are uncommon.

Causes

Greenstick fractures mostly occur in infants or toddlers, sometimes in children during their early adolescent and pre-adolescent years. They are partial-thickness fractures (a break in a bone that doesn’t completely break it) characterized by a break on one side and a bend on the other. Buckle fractures and bow fractures are different types of partial-thickness fractures. Greenstick fractures commonly occur:

  • In children under 10 years old
  • Occurs when a child reaches out to break a fall
  • During motor vehicle collisions
  • Sports
  • Direct impacts
  • Non-accidental trauma

It is more common in long bones, including:

  • Radius
  • Ulna
  • Humerus
  • Fibula
  • Tibia
  • Clavicle

The fracture pattern often indicates a limb’s bending or contortion.

Symptoms

Greenstick fracture symptoms can include:(Atanelov Z, & Bentley T.P. 2025)

  • Localized swelling
  • Localized bruising
  • Pain
  • Deformity, such as the affected body part looking crooked or out of alignment.

Treatment

If the bone is not significantly bent out of alignment, a splint or cast may be all that is necessary to treat the break. If the bone is visibly out of alignment, it must be manually straightened before the limb is put into a cast. If the break is severe, surgery may be required. Fortunately, a growing skeleton can remodel bone, so fractured bones can often realign themselves over time with minimal intervention. Healing depends on various factors, including:

  • Age of the child
  • The severity of the break
  • Location of the break

The younger the child is, the faster the recovery will be. (Pountos I., Clegg J., & Siddiqui A. 2010)

Sometimes, the fracture must be bent back and repositioned in a fracture reduction procedure. An anesthetic may be used as the doctor manually realigns the bone into the correct position. After the reduction, a cast or splint will stabilize the bone and maintain proper alignment. Depending on how quickly the bone heals, a cast may be necessary for a few weeks, months, or longer, depending on the patient and/or underlying conditions.

Healing

  • Healing involves specialized cells that gradually rebuild and fine-tune the new bone.
  • The average time for a greenstick fracture to heal completely may take four weeks.

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.


Building a Stronger Body


References

Wolfe, J. A., Wolfe, H., Banaag, A., Tintle, S., & Perez Koehlmoos, T. (2019). Early Pediatric Fractures in a Universally Insured Population within the United States. BMC pediatrics, 19(1), 343. https://doi.org/10.1186/s12887-019-1725-y

Atanelov, Z., & Bentley, T. P. (2025). Greenstick Fracture. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30020651

Pountos, I., Clegg, J., & Siddiqui, A. (2010). Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single-blind study. Journal of children’s orthopaedics, 4(4), 321–326. https://doi.org/10.1007/s11832-010-0269-3

Pectoralis Minor: Understanding Its Role in Posture

For individuals dealing with posture problems causing neck, back, and shoulder pain, can pectoralis minor stretches designed to work these areas be a part of physical therapy or as regular exercises at home?

Pectoralis Minor Muscle Stretches

The pectoralis minor is a small, triangular muscle situated deep to the pectoralis major in the anterior chest wall. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction and connects to the coracoid process of the scapula. The pectoralis minor helps with posture, mobility, and shoulder stability and aids breathing. Muscle tightness can cause pain in the chest, shoulder, and neck and a restricted range of motion. Strain and injuries can occur during activities involving overhead movements or forceful pushing. Pectoralis minor stretches are designed to work these muscles that span the ribs and connect to the shoulder to help improve posture and relieve pain and chest weakness. They can help reduce muscle tightness and other conditions like thoracic outlet syndrome. (Kaur U. et al., 2023) (Wagner E. R. et al., 2023) Talk with a healthcare provider Before starting any exercise or stretching program.

Corner Pectoralis Stretch

A corner pec stretch is similar to a wall push-up, except the emphasis is on staying in a position that lengthens the chest muscles. It’s important to move the whole body as a unit and not bend.

  • Stand facing a corner with a relaxed, upright posture.
  • Place your feet so they are parallel, and bend your knees slightly.
  • Stay as relaxed as possible during the movement to protect your joints.
  • Keep your gaze forward.
  • Place your forearms and palms over the walls where two walls connect at a right angle.
  • With your elbows bent to 90 degrees, move forward into the corner of the wall until you feel a comfortable stretch in the pectorals.
  • Keep the hips straight.
  • Hold the position for up to 30 seconds.
  • Return to starting position.
  • If you need a deeper stretch, move the arm position up or down. (University of North Carolina School of Medicine, 2020)

Doorway Stretch

The doorway stretch is similar to the corner stretch. It works the pectoralis major and the minor muscles and helps with mobility. To perform: (Maryland Pain & Wellness Center, 2025)

  • Stand in a doorway with your feet placed together.
  • Place the palms and forearms on either side of the doorway.
  • Your elbows should be even with your shoulders and bend at a 90-degree angle.
  • Keep your back straight.
  • Take a step forward, leaning into the doorway.
  • You should feel the stretch in the muscle.
  • Repeat the stretch with the other foot.

Exercise and ergonomic changes to your chair or desk height can help improve posture and relieve muscle tightness. (Kaur U. et al., 2023)

T Stretch

The T stretch stretches the front of the chest and is done on the floor, typically with a foam roller placed directly under the spine. To perform: (OrthoCarolina, N.D.)

  • Lie down on your back with the foam roller aligned to the spine.
  • Make sure your head and tailbone are supported.
  • Open your arms straight out like a T.
  • Hold the position while stretching.

Y Stretch

The Y stretch is similar to the T stretch; both reduce chest muscle tightness and discomfort. To perform: (OrthoCarolina, N.D.)

  • Use the same foam roll position, lying on your back with the head and tailbone supported and aligned.
  • Stretch the arms out above your head, placing them into the shape of a Y.
  • Allow the chest muscles that connect to the arms to relax.

Studies have examined how quickly a prone scapular retraction can help stretch the back and shoulders. Results suggest the exercises must be performed longer before the pectoralis minor is lengthened to improve symptoms. (Dye J., Allyn M., & Frank C. 2024) However, further research is needed.

Health Conditions

Pectoralis minor stretches may be part of a personalized therapy program to improve mobility, posture, and/or breathing and sleep quality with health conditions that include:

Stretching and strengthening exercises can help improve their flexibility and function. Exercises can improve strength and function by standing or lying down, depending on the stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

The pectoralis minor muscles are often overlooked in clinical examinations but can contribute to musculoskeletal pain and dysfunction. A healthcare provider can teach about stretches, how they can help, and whether they are safe for the individual’s injury and/or condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal 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.


Doorway Stretching Routine


References

Kaur, U., Shrestha, D., Hussain, M. A., Dalal, P., Kalita, M., Sharma, V., & Sharma, S. (2023). Prompt Impact of Muscle Energy Technique on Pectoralis Muscle Tightness in Computer Users: A Quasi-Experimental Study. Journal of Lifestyle Medicine, 13(2), 123–128. https://doi.org/10.15280/jlm.2023.13.2.123

Wagner, E. R., Gottschalk, M. B., Ahmed, A. S., Graf, A. R., & Karzon, A. L. (2023). Novel Diagnostic and Treatment Techniques for Neurogenic Thoracic Outlet Syndrome. Techniques in hand & upper extremity surgery, 27(2), 100–114. https://doi.org/10.1097/BTH.0000000000000419

University of North Carolina School of Medicine. (2020). Upper Body Stretching. https://www.med.unc.edu/htcenter/wp-content/uploads/sites/711/2020/04/Upper-Body-Stretching.pdf

Maryland Pain & Wellness Center. (2025). Stretches to Help with Strained Chest Muscles. Maryland Pain & Wellness Center Restoring Hope, Rebuilding Lives. https://www.marylandpainandwellnesscenter.com/blog/stretches-to-help-with-strained-chest muscles#:~:text=With%20your%20knees%20bent%20and,assist%20in%20deepening%20the%20stretch.

OrthoCarolina. (N.D.). Stretching Guide to Ease Tight Muscles. https://www.orthocarolina.com/storage/wysiwyg/stretching_guide_1.pdf

Dye, J., Allyn, M., & Frank, C. (2024). Is there an immediate effect on pectoralis minor length after performing a prone scapular retraction exercise using typical sets and repetitions in pain-free participants? Journal of bodywork and movement therapies, 40, 1014–1019. https://doi.org/10.1016/j.jbmt.2024.07.026

Chankavee, N., Amatachaya, S., Hunsawong, T., Thaweewannakij, T., & Mato, L. (2023). Effects of modified long stick exercise on hyperkyphosis, muscle imbalance, and balance control in elderly community-dwelling women with hyperkyphosis. Journal of back and musculoskeletal rehabilitation, 36(5), 1151–1162. https://doi.org/10.3233/BMR-220350

Liao, Y. X., Saiken, A., Chang, X., Guo, Y. F., Tan, Z., Deng, F., Meng, Q. L., Zhen, H., Li, Y. M., & Fang, B. M. (2025). Associations of fat, bone, and muscle indices with disease severity in patients with obstructive sleep apnea-hypopnea syndrome. Sleep & breathing = Schlaf & Atmung, 29(1), 82. https://doi.org/10.1007/s11325-024-03241-8

Thongchote, K., Chinwaro, U., & Lapmanee, S. (2024). Effects of scapulothoracic exercises on chest mobility, respiratory muscle strength, and pulmonary function in male COPD patients with forward shoulder posture: A randomized controlled trial. F1000Research, 11, 1284. https://doi.org/10.12688/f1000research.126832.2

Dates: Why You Should Include Them in Your Diet

Can adding dates to one’s diet be nutritious and provide various health benefits for individuals looking for a naturally sweet snack?

Dates

Dates are a type of dried fruit from the date palm tree. Dates are a healthy source of fiber, calcium, magnesium, potassium, niacin, folate, vitamin A, beta-carotene, lutein, and selenium. They can be a healthier alternative to refined sugar because they have a low glycemic index and do not cause a rapid spike in blood sugar levels. They are a rich source of nutrients, including:

  • Fiber: High in fiber, which promotes good digestion and helps keep you feeling full.
  • Potassium: This is essential for heart health and muscle function.
  • Magnesium: supports bone health and energy production.
  • Antioxidants: which protect the body from damage caused by free radicals.
  • Vitamins: a good source of vitamins B6, K, and A.

Consuming them in moderation is recommended, especially for individuals who are trying to lose weight or have diabetes. They are high in sugar, so individuals need to be mindful to avoid or limit additional sources of sugar. Nutritionists and dieticians recommend a modest dose of two large or three small dates, which is around 50 grams and provides half the sugar and calories.

Benefits

Lower Cholesterol

Research has shown that eating dates may also help lower cholesterol and triglyceride levels. However, further research is needed as the current evidence is still inconclusive. (Mirghani H. O. 2024) A recent meta-analysis also showed no significant effect on LDL cholesterol but reduced total cholesterol in individuals with type 2 diabetes.

Help Regulate Blood Sugar

Pitted dates generally don’t contain added sugars but can still contain a significant amount of natural sugars in sucrose, glucose, or fructose. Although their high sugar level may prevent individuals from eating dates as a healthy snack, a key difference between dates and sugary drinks, snacks, or other processed foods is that they contain high levels of fiber. Because of the fiber, which slows glucose absorption in the bloodstream, they also have a low glycemic index, which causes a smaller spike in blood sugar levels. (Mirghani H. O. 2021) Using dates as a sweetener can also be a healthier alternative to refined sugar and can be used in recipes to replace sugar. However, portion control is important.

Support Gut Health

Since dates are high in fiber, they can help the gastrointestinal tract but should be eaten in moderation as part of a balanced, healthy diet. However, they are recommended to be eaten with other fiber-rich foods, specifically those with lower sugar, that includes:

  • Leafy greens
  • Non-starchy vegetables
  • Whole grains
  • Legumes
  • Nuts
  • Seeds

Adding these foods to a diet can also benefit the microbiome. Dates and other fruits can improve the ratio of beneficial gut microbiota. (Eid N. et al., 2015) Eating too many dates could also cause diarrhea, but eating a few daily can help constipation.

Alternatives

  • Other dried fruits, such as prunes, figs, and apricots, are alternatives, but fresh fruits are an even better choice as they are much lower in calories.

Injury Medical Chiropractic and 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.


Personalized Medicine and Wellness


References

Mirghani H. O. (2024). Effect of dates on blood glucose and lipid profile among patients with type 2 diabetes. World journal of diabetes, 15(6), 1079–1085. https://doi.org/10.4239/wjd.v15.i6.1079

Mirghani H. O. (2021). Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pakistan journal of medical sciences, 37(4), 1230–1236. https://doi.org/10.12669/pjms.37.4.4112

Eid, N., Osmanova, H., Natchez, C., Walton, G., Costabile, A., Gibson, G., Rowland, I., & Spencer, J. P. (2015). Impact of palm date consumption on microbiota growth and large intestinal health: a randomised, controlled, cross-over, human intervention study. The British journal of nutrition, 114(8), 1226–1236. https://doi.org/10.1017/S0007114515002780

Back Cracking: Can It Relieve Your Back Pain?

Are there benefits to back cracking, risks, and how can it be done safely?

Back Cracking

Back cracking is intentionally applying pressure or twisting movements, producing a popping or cracking sound in the spine. Back cracking involves stretching or extending the spine. In most cases, it is considered safe when done gently as it can provide temporary relief from back pain and stiffness by:

  • Stretching the ligaments and muscles around the spine
  • Releasing gas bubbles that may be causing pressure
  • Improving joint mobility

Mechanism of Action

  • Cracking your back creates small gas bubbles in the synovial fluid (the lubricating fluid in the joints).
  • These bubbles form when the pressure in the joints is suddenly released, causing a popping or cracking sound.

It is generally safe, but there are certain conditions under which individuals should avoid cracking their backs.

Popping Sound

Research has used a new type of magnetic resonance imaging (MRI), cine MRI, to study the noise source. Cine MRI produces moving images.

  • This study using this MRI found that the formation of bubbles makes a popping sound.
  • The popping sound does not come from the popping of bubbles in the synovial fluid, as previously believed. (Kawchuk G. N. et al., 2015)
  • When someone cracks their back, the force pulls the bones of the joint apart, causing the pressure within the joint to drop and form a bubble, which eventually dissipates. (Kawchuk G. N. et al., 2015)

Crepitus

  • Crepitus is the medical term for cracking or popping noise from joints.
  • It is not a condition or disease but can be a symptom of one.
  • Other terms include clicking or crunching.

Is It Safe To Perform Daily?

Back cracking once a day is generally considered safe. But if it causes pain or swelling, then stop and contact a healthcare provider. If someone feels the need to crack their back more throughout the day, it could be a sign that they need to see a professional chiropractic healthcare provider. (AICA Orthopedics, 2022) Individuals may crack their backs to address certain conditions or to relieve various discomfort symptoms that can include: (National Center for Complementary and Integrative Health, 2025)

  • Headache
  • Neck pain
  • Lower back pain
  • Sciatica

Individuals may often experience mild side effects like headache, stiffness, or pain. These side effects tend to resolve within a day. Though back cracking can provide temporary relief for some conditions, some serious side effects like neurological problems or strokes have been reported. (National Center for Complementary and Integrative Health, 2025)

Stretches and Movements

When someone needs to crack their back, they can perform a spine stretch. Here are a couple of stretches and movements. (American Academy of Orthopedic Surgeons, 2022)

Sitting Rotation Stretch

  • Sit on the floor with both legs straight.
  • Cross the right foot over the left leg.
  • Rotate the upper body to the right side and press against the right knee with the left elbow.
  • Hold the stretch for 30 seconds and come back to the center.
  • Repeat on the other side.

Knee to Chest

  • Lie flat on the ground.
  • Lift one leg and bring the knee to the chest, pulling the knee in with your hands.
  • Hold for five seconds.
  • Repeat with the other leg.

Several back-cracking assistive devices, such as poles and wheels, are available. Talk to a healthcare provider to determine the right type and ensure it is safe for you and your condition or injury.

Individuals Who Should Avoid Back Cracking

Back cracking can cause additional stress or damage to the joints in those with back injuries or other conditions. Individuals with these conditions should avoid back cracking (AICA Orthopedics, 2022)

  • Numbness or tingling of the arms or legs.
  • Osteoporosis
  • Spinal cancer
  • Spinal abnormalities
  • Individuals who have a high stroke risk.

A Professional Back Adjustment

A chiropractor is a healthcare provider who specializes in spine and spinal adjustments. They adjust the spine and other areas of the body to correct misalignment problems, reduce and relieve pain, and allow the body to recover independently. (National Library of Medicine. MedlinePlus, 2023) The chiropractor will take a health history to learn about previous injuries and conditions. Then, they will evaluate the patient and determine the best course of action. Although a chiropractor performs spinal adjustments, they may also incorporate other treatments, including: (National Library of Medicine. MedlinePlus, 2023)

  • Stretching
  • Non-surgical decompression and traction
  • Acupuncture
  • Muscle Energy Technique (MET)
  • Exercise routines
  • Heat
  • Ice
  • Electrical stimulation
  • Dietary supplements
  • Nutrition and lifestyle counseling

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 Secrets


References

Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470

AICA Orthopedics. (2022). Is cracking your back bad? https://aica.com/is-cracking-your-back-bad/

National Center for Complementary and Integrative Health. (2025). Spinal manipulation: what you need to know. Retrieved from https://www.nccih.nih.gov/health/spinal-manipulation-what-you-need-to-know

American Academy of Orthopedic Surgeons. (2022). Spine conditioning program. https://orthoinfo.aaos.org/en/recovery/spine-conditioning-program/

National Library of Medicine. MedlinePlus.  (2023). Chiropractic. Retrieved from https://medlineplus.gov/chiropractic.html

Walking Backward to Alleviate Back Pain

Can walking backward on a treadmill aid in treating conditions and injuries, improving strength, gait, and mobility in the lower extremities and knee, hip, and ankle range of motion (ROM)?

Walking Backward On A Treadmill

Walking backward is often used in physical therapy to treat multiple conditions and injuries and help improve strength, gait, balance, and mobility in the lower extremities. It is also used to improve knee, hip, and ankle range of motion and lower back pain and burn calories.

The Difference Backward vs. Forward

The difference from forward walking is that certain motions are normal gait characteristics.

  • First, the leg swings through the air, and the heel lands on the ground.
  • Then, the straight knee bends slightly as you roll from heel to toe.
  • As this occurs, the opposite leg rolls from the toes and up into the air.
  • This heel-to-toe motion repeats, and normal walking takes place.

Reverse walking creates the opposite gait process.

  • The leg swings through the air and reaches backward with a bent knee.
  • The toes contact the ground, and the bent knee straightens as you roll from toe to heel.
  • Then, the heel leaves the ground with the knee straight, repeating the process.
  • The toe-to-heel gait can provide various benefits. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Benefits

Walking backward on a treadmill benefits include:

  • Improved range of motion in the knee
  • Hamstring flexibility and mobility
  • Quadriceps strengthening

Walking backward also helps burn calories, improve heart function, and improve balance and stability. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Knee Range of Motion

  • Reverse walking can help increase knee extension range of motion. (Zhang M. et al., 2022)
  • Individuals with knee injuries, surgeries, or arthritis may lose their knee extension or the knee’s ability to straighten.
  • The bent knee straightens fully when walking backward, moving from the toes onto the heel.
  • This helps to improve the range of motion into knee extension.

Quadriceps Function

  • Reverse walking can improve the function of the quadriceps muscles in the upper thighs. (Alghadir A. H. et al., 2019)
  • The quads are active when straightening the knee.
  • Exercises like quad sets, short arc quads, and straight leg raises increase quad strength.

Hamstring Flexibility

  • The hamstrings are located in the back of the upper thighs and work to bend the knees and extend the hips.
  • For individuals with tight hamstrings, a therapist may have you walk backward on the treadmill to improve the flexibility of the muscle group. (BBC, 2023)
  • When walking backward, the hamstring contracts to bend the knee as it swings through the air.
  • Then, the hamstring is stretched from the toe to heel movement, and the knee straightens.

Balance, Gait, and Mobility

  • Reverse walking can improve gait characteristics after an injury, surgery, or illness. (Balasukumaran T., Olivier B., & Ntsiea M. V. 2019)
  • Walking backward can help reset one’s gait and improve one’s ability to walk forward.
  • A study on stroke patients found that backward walking training was superior to standing balance training for improving balance and walking speed. (Rose, D. K. et al., 2018)

Burns Calories

  • Backward walking has been found to burn more calories than forward walking.
  • Walking backward uses up about 40% more calories per minute than forward walking at the same speed. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Heart and Lung Function

  • Walking backward on a treadmill can also benefit heart and lung health.
  • Backward walking is more challenging and forces the individual to work harder.
  • Research shows it requires more oxygen and places more demands on the cardiovascular system. (Thomas K. S., Hammond M., & Magal M. 2018)
  • As a result, it improves heart and lung health better.

Conditions That Benefit

Individuals with a lower extremity impairment that results in loss of normal walking mobility may benefit from reverse walking. Common conditions that may help include: (BBC, 2023) (DelMastro H. M. et al., 2023)

  • Hamstring strain
  • Sciatica with tightness in hamstrings
  • Hip, knee or ankle surgery
  • Lower extremity fracture
  • Cerebral palsy
  • Multiple sclerosis
  • Parkinson’s disease
  • Stroke

A physical therapist will decide if an individual’s condition warrants reverse walking as part of a rehabilitation program.

Injury Medical Chiropractic and 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.


Control Foot Motion and Posture


References

Cha, H. G., Kim, T. H., & Kim, M. K. (2016). Therapeutic efficacy of walking backward and forward on a slope in normal adults. Journal of Physical Therapy Science, 28(6), 1901–1903. https://doi.org/10.1589/jpts.28.1901

Zhang, M., Pang, J., Lu, J., Kang, M., Chen, B., Jones, R. K., Zhan, H., & Liu, A. (2022). The Immediate Effect of Backward Walking on External Knee Adduction Moment in Healthy Individuals. Journal of Healthcare Engineering, 2022, 4232990. https://doi.org/10.1155/2022/4232990

Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial). BMC musculoskeletal disorders, 20(1), 159. https://doi.org/10.1186/s12891-019-2537-9

BBC. (2023). Why walking backwards can be good for your health and brain. https://www.bbc.com/future/article/20231110-why-walking-backwards-can-be-good-for-your-health-and-brain

Balasukumaran, T., Olivier, B., & Ntsiea, M. V. (2019). The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. Clinical Rehabilitation, 33(2), 171–182. https://doi.org/10.1177/0269215518801430

Rose, D. K., DeMark, L., Fox, E. J., Clark, D. J., & Wludyka, P. (2018). A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial. Journal of Neurologic Physical Therapy: JNPT, 42(1), 12–21. https://doi.org/10.1097/NPT.0000000000000210

Thomas, K. S., Hammond, M., & Magal, M. (2018). Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. Gait & posture, 65, 20–25. https://doi.org/10.1016/j.gaitpost.2018.06.168

DelMastro, H. M., Ruiz, J. A., Simaitis, L. B., Gromisch, E. S., Neto, L. O., Cohen, E. T., Wong, E., Krug, R. J., & Lo, A. C. (2023). Effect of Backward and Forward Walking on Lower Limb Strength, Balance, and Gait in Multiple Sclerosis: A Randomized Feasibility Trial. International journal of MS care, 25(2), 45–50. https://doi.org/10.7224/1537-2073.2022-010

Bicycle Stationary Conversion for Home Workouts

Can converting a bicycle into a stationary bike be a way for individuals to exercise more while still enjoying cycling?

Bicycle Stationary Conversion

Is your bike collecting dust in the garage? Do you miss riding, but the weather or temperatures keep you indoors?  Why not quickly and painlessly turn your bike into a stationary bike? An indoor stationary bike is a great way to maintain physical activity while avoiding inclement weather and outdoor elements. Plus, bicycle stationary conversion in your home, office, or garage is quick and straightforward. A bike trainer or roller is needed to convert a bicycle into a stationary bike. The bike is mounted onto the trainer stand, and its rear axle is replaced with a special axle provided with the trainer kit to secure it and hold the wheel in place while allowing you to pedal, creating resistance for indoor cycling.

Cycling

Bicycle stationary conversion isn’t only for die-hard cyclists. Research shows indoor cycling is a great way to stay healthy and consistent with your workouts. One study showed that indoor cycling improves aerobic capacity, blood pressure, lipid profile, and body composition. (Chavarrias, M. et al., 2019)

Stationary Bikes Types

For those who don’t have the space or know that they won’t regularly use a stationary bike, indoor bike trainers and rollers can provide convenient, economical, and compact options. Whether individuals want to exercise more, maintain a riding schedule, or train for an event, trainers and rollers can be highly effective tools for any cyclist. However, choosing between a bike trainer and rollers varies depending on the pros and cons. Selecting the right equipment depends on several factors, including:

  • Personal needs
  • Space – indoor or garage.
  • Cycling experience

Most cyclists, even hobbyists, prefer indoor cycling bikes over traditional stationary bikes because they are riding a real bicycle, including the positioning and pedaling, compared to upright, air, or recumbent bikes.

Trainer

A bike trainer is a stand that lets an individual ride a regular bicycle while stationary. Cyclists often use it to warm up before races, and it comes in handy when weather conditions or time constraints prevent riding outdoors. Most trainer stands can accommodate bicycles. Trainers are suitable for beginners and professional riders. There are two types of indoor bike trainers.

Direct-drive

  • Direct-drive trainers attach to the bike’s rear dropouts, replacing the wheel and providing a direct connection to the resistance unit.
  • These can cost more, but they’re worth the investment because they’re more accurate and deliver the highest resistance levels.

Friction

  • A small roller is installed against the rear wheel with friction trainers, which use magnetic or fluid resistance.
  • These are typically lighter and easier to transport than direct-drive trainers but are less accurate and provide less resistance.

Rollers

Rollers are the most basic type of indoor stationary bike but may not be the best option for individuals new to indoor cycling. This is because it requires advanced cycling techniques, such as balancing and keeping the front tire straight while riding. The cycle is on rollers instead of being fixed, allowing the resistance to range from zero to the equivalent of a direct-drive trainer. Rollers help refine pedaling technique and improve cycling form because you balance and stabilize while riding.

Conversion – What Is Needed

The most important equipment needed to convert the cycle is a bike stand, which will be the foundation of the stationary bike setup. (Bike To Work Day, 2025) There are two-piece stands and one-piece stands. (Bike To Work Day, 2025) Tools like an Allen wrench may be needed. Various bike trainer kits contain all the parts needed for this conversion, but extra standard tools may be required to remove the back wheel and replace the axle.

  • Choose the right trainer: Consider your bike type, desired resistance levels, and budget.
  • Install the trainer: Follow the manufacturer’s instructions to position and secure the trainer properly.
  • Mount the bike: Remove the rear wheel quick release, insert the trainer’s axle, and tighten it securely.
  • Adjust resistance: Most trainers have a knob or lever to control the difficulty level.
  • If you are uncertain whether your bike stand is set up correctly or having issues with the installation, contact a professional bike mechanic. They can help get the stationary bike up and running properly.

Considerations

  • Tire wear: Using a dedicated trainer tire for the rear wheel can minimize wear and tear.
  • Noise level: Some trainers can be noisy, especially wheel-on types.
  • Stability: Ensure the bike is properly secured on the trainer and your training area is stable.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal 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

Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Pérez-Gómez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8), 452. https://doi.org/10.3390/medicina55080452

Bike To Work Day. (2025). How to turn a bike into a stationary bike: Things to know. https://biketoworkday.us/turn-a-bike-into-a-stationary-bike/#Setting_up_Your_Stationary_Bike