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By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises, Gut Health , , , , , , , , , , , , , , , , , ,

Tai Chi for Gut Health and Improved Digestion

For individuals dealing with digestive issues and conditions, can incorporating Tai Chi help improve gut health?

Tai Chi For Gut Health

Tai Chi is an exercise that has been referred to as moving meditation. The practice is rooted in Chinese medicine, which fuses martial arts and meditation. The art of Tai Chi is used to improve physical health. It can also positively impact gut health by improving digestive function, reducing inflammation, and influencing the gut microbiota composition. The slow, controlled movements and deep breathing can stimulate abdominal and pelvic organs, promoting digestion. Additionally, it has been shown to reduce inflammation in the gut and increase the diversity of gut bacteria, including beneficial butyrate-producing bacteria. (Kang D., Wang X., & Wang J., 2023)

Types

The idea is to slow down your mind and body by repeating rhythmic choreography and breathwork for about 30 to 60 minutes, culminating in finding a sense of inner peace and tranquility.

Primary Forms/Styles

These include Chen, Yang, Wu, Sun, and Wu/Hao. Each follows the same origins and principles with variations. (Tai Chi for Health Institute, 2007)

Chen Style

  • Considered the oldest and original style, the Chen style is characterized by explosive power, low stances, and a combination of fast and slow movements, including jumping, kicking, and striking.
  • Chen also utilizes a movement called “silk reeling,” a spiral-esque, flowing movement that starts at the feet and moves into the hands.

Yang Style

  • Yang is often considered the most popular form of Tai Chi and is practiced worldwide.
  • Yang Tai Chi focuses more on improving flexibility through grand, sweeping movements executed slowly and gracefully.

Wu Style

  • Wu Tai Chi emphasizes small, compact movements and a medium stance. Its focus is on extending the body by leaning forward and backward.

Sun Style

  • Sun Tai Chi combines elements of Tai Chi, Xing Yi, and Ba Gua, resulting in a unique style with fluid, circular movements.

Hao Style

  • This style is characterized by small-frame movements focusing on accurate position and internal strength.

Gut Health

By improving various aspects of gut health, Tai Chi can contribute to overall well-being. (Kang D., Wang X., & Wang J., 2023)

Relieves Stress and Anxiety

  • Stress can lead to digestive problems
  • Tai Chi can indirectly benefit gut health by reducing stress levels.
  • Its emphasis on slow movements and deep breathing can help reduce stress.
  • Combining meditative practices with physical movement can help calm the mind, improve focus, and even trigger the release of endorphins.

Improved Digestion

  • Gentle, flowing movements, particularly those involving the diaphragm, can massage and stimulate the abdominal and pelvic organs, aiding the digestive process.

Reduced Inflammation

  • Tai Chi can help reduce gut inflammation, a common issue in conditions like inflammatory bowel disease (IBD).

Gut Microbiota Changes

  • Tai Chi has been found to positively influence the gut microbiota composition, increasing the diversity and abundance of beneficial bacteria.

Improved Gut Barrier Function

  • Tai Chi may help improve the integrity of the gut barrier, which is essential for preventing harmful substances from entering the bloodstream and causing inflammation.

Increased Butyrate Production

  • Tai Chi can promote the growth of butyrate-producing bacteria, which are important for intestinal health and can reduce inflammation.

Overall Health Benefits

Increases Cognitive Function

  • In addition to improving your mental well-being, Tai Chi has also been found to boost cognitive abilities.
  • A meta-analysis stated that physical exercise, in general, improves cognitive function, and researchers specifically recommended Tai Chi for elderly individuals since it’s a gentler and more accessible form of physical exercise that also combines mental exercises through repeated choreography. (Yin Wu, et al., 2013)

Increases Flexibility and Agility

  • Similar to yoga, Tai Chi often involves body extensions that can improve flexibility and agility.
  • This is useful in daily activities and makes you more agile and capable in other sports.

Improves Balance and Coordination

  • In addition to improving flexibility and agility, the intricate movements can help balance and coordination.
  • This skill is useful in daily life.
  • It can help with fine motor skills and even prevent trips, stumbles, falls, and other sports.

Enhances Strength and Stamina

  • As with any form of physical exercise, Tai Chi can build upon existing strength and stamina.
  • With ongoing practice, individuals become leaner, their muscles are more defined, and they can exercise longer.

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider to learn what interventions would help the most. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Body Maintenance

References

Kang, D., Wang, X., & Wang, J. (2023). Intervention study of tai chi training on the intestinal flora of college student basketball players. Medicine, 102(36), e35044. https://doi.org/10.1097/MD.0000000000035044

Wu Y, W. Y., Burgess EO, Wu J. (2013). The effects of Tai Chi exercise on cognitive function in older adults: A meta-analysis. Journal of Sport and Health Science, 2(4), 193-203. https://doi.org/https://doi.org/10.1016/j.jshs.2013.09.001

Tai Chi for Health Institute. (2018). History of Tai Chi. https://taichiforhealthinstitute.org/history-of-tai-chi/#:~:text=Based%20on%20Qigong%20and%20martial%20art%20techniques,It%20contains%20explosive%20power%20and%20low%20stances.

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises , , , , , , , , , ,

Calisthenics: Transform Your Body Naturally

Get started with calisthenics and experience amazing results. Bodyweight training can elevate your fitness game effortlessly.

Introduction

Musculoskeletal disorders (MSDs) are among the leading causes of pain, disability, and diminished quality of life worldwide. Whether stemming from repetitive occupational stressors, sedentary behavior, age-related degeneration, or trauma, these disorders disrupt the foundational biomechanics of the human body. As a nurse practitioner with two decades of experience in physical and functional medicine, I have observed how integrated, non-surgical interventions—particularly calisthenics and chiropractic care—offer sustainable solutions for patients grappling with pain and mobility challenges.

This article outlines how calisthenics, or bodyweight movement training, when combined with chiropractic care, provides a comprehensive, cost-effective, and evidence-informed approach to restoring musculoskeletal health. We’ll also explore specific exercises, patient protocols, and the neurobiological underpinnings that make this combination both powerful and accessible.

Understanding Musculoskeletal Disorders: A Functional Medicine Perspective

Musculoskeletal disorders encompass a wide range of conditions affecting the bones, muscles, tendons, ligaments, and joints. These include:

  • Low back pain
  • Cervical radiculopathy
  • Myofascial pain syndrome
  • Shoulder impingement
  • Chronic joint stiffness and instability
  • Sacroiliac dysfunction
  • Postural imbalances and movement disorders

From a functional medicine lens, MSDs are not isolated pathologies but often part of a larger systemic imbalance involving inflammation, poor posture, neuromuscular dysfunction, and biomechanical inefficiencies.

Importantly, many patients present with overlapping risk profiles—including obesity, insulin resistance, sedentary lifestyle, poor proprioception, and autonomic dysregulation—that exacerbate their musculoskeletal pain. In these cases, surgery should be a last resort. Instead, conservative, holistic interventions often yield long-term relief and functional restoration without the side effects and costs associated with pharmacological or surgical approaches.

Why Non-Surgical Interventions Matter

Non-surgical treatments, especially those grounded in functional and physical medicine, provide several advantages:

  • Cost-effectiveness: Reduces long-term healthcare spending.
  • Minimized risk: Avoids complications from anesthesia, surgical infection, or post-operative dependency on opioids.
  • Root-cause resolution: Treats underlying movement dysfunction, not just the symptoms.
  • Sustainability: Teaches patients to manage their health independently through lifestyle, movement, and alignment.

Among these interventions, two stand out: chiropractic spinal care and calisthenics-based rehabilitation.

Calisthenics: The Foundation of Functional Movement

What Is Calisthenics?

Calisthenics refers to bodyweight resistance training aimed at improving strength, coordination, balance, and flexibility. Exercises such as squats, lunges, planks, push-ups, glute bridges, and dynamic mobility drills engage multiple muscle groups without external weights, making them safe, scalable, and accessible to all fitness levels.

Unlike high-intensity interval training (HIIT) or gym-based hypertrophy programs, calisthenics emphasizes:

  • Neuromuscular integration
  • Proprioceptive feedback
  • Core stabilization
  • Functional joint loading

🔍 SEO Keywords: calisthenics for low back pain, bodyweight exercises for musculoskeletal pain, functional movement therapy, non-surgical back pain relief

Calisthenics and Health Optimization

Evidence shows that regular participation in calisthenic-based movement routines can:

  • Improve metabolic health and reduce risk of chronic disease (Bellissimo et al., 2022)
  • Reverse deconditioning associated with sedentary behavior
  • Enhance musculoskeletal and cognitive function by improving circulation and neuroplasticity (Osuka et al., 2020)

This makes calisthenics not only a therapeutic intervention but also a preventive strategy for aging-related degeneration and functional decline.

Can Core Exercises Help With Back Pain?-Video

Chiropractic Care: Restoring Biomechanical Integrity

What Does Chiropractic Care Do?

Chiropractic care focuses on restoring spinal and joint alignment through manual and mechanical manipulations. When spinal segments are misaligned—known as subluxations—they interfere with normal neuromuscular signaling and alter gait, posture, and joint mechanics.

Key benefits include:

  • Pain reduction through neural reflex modulation
  • Improved range of motion in affected joints
  • Myofascial release and decreased muscle hypertonicity
  • Autonomic balance through vagal nerve upregulation

Coulter et al. (2018) documented chiropractic’s efficacy in reducing back pain severity, improving function, and lowering opioid dependence in patients with chronic low back pain.

The Synergy Between Calisthenics and Chiropractic Care

While chiropractic adjustments realign and decompress joints, calisthenics reinforces these changes by retraining the neuromuscular system. This dual approach ensures that postural corrections are maintained long-term through active engagement and movement retraining.

Key Integration Strategies:

  1. Post-Adjustment Stabilization
    Patients are guided through low-load activation drills (e.g., glute bridges, bird-dogs) immediately after spinal manipulation to “lock in” proper alignment via muscle memory.
  2. Corrective Exercise Protocols
    Calisthenic movements are used to correct postural syndromes like upper-crossed and lower-crossed syndrome by strengthening underactive muscles and releasing hypertonic patterns.
  3. Home-Based Exercise Programs
    These simple, equipment-free routines promote daily movement, increase patient autonomy, and reduce reliance on in-office care.
  4. Neuromuscular Re-education
    Calisthenics enhances proprioceptive feedback and motor planning, essential for individuals with chronic pain and poor movement literacy (Mear et al., 2022).

Evidence-Based Calisthenics for Musculoskeletal Pain

Calisthenics for Low Back Pain: 4 Foundational Exercises

1. Glute Bridge

Target: Gluteus maximus, hamstrings, core
Why: Strengthens posterior chain to decompress lumbar spine
How to Perform:

  • Lie on your back, knees bent, feet flat.
  • Engage core, press through heels, lift hips.
  • Hold 5 seconds; repeat 15 reps × 3 sets.

2. Bird-Dog

Target: Multifidus, erector spinae, transverse abdominis
Why: Enhances spinal stability and cross-body coordination
How to Perform:

  • On all fours, keep spine neutral.
  • Extend opposite arm and leg; hold 10 seconds.
  • Alternate sides; repeat 10 reps per side × 3 sets.

3. Wall Sit

Target: Quadriceps, glutes, lumbar stabilizers
Why: Promotes spinal neutrality and knee-hip coordination
How to Perform:

  • Slide into seated position against a wall.
  • Hold for 20–30 seconds; repeat 3–5 times.

4. Pelvic Tilt

Target: Core musculature, pelvic stabilizers
Why: Teaches lumbar-pelvic control and relieves tension
How to Perform:

  • Supine with knees bent.
  • Flatten lumbar spine against the floor.
  • Hold 10 seconds; repeat 10–15 reps × 3 sets.

💡 Pro Tip: Begin with isometric holds and progress to dynamic variations once stability improves.

Calisthenics in Functional Rehabilitation Protocols

Functional medicine emphasizes root-cause resolution and the restoration of systemic balance. In musculoskeletal care, this means addressing:

  • Inflammation and oxidative stress with nutrition and supplementation
  • Mitochondrial dysfunction with movement and breathwork
  • Autonomic dysregulation via vagal toning and neuromuscular re-patterning

Calisthenics fits into this paradigm by improving cellular oxygenation, lymphatic flow, and biomechanical alignment—without the need for expensive gym equipment or medication.

Case Example: Chronic Low Back Pain

A 48-year-old patient presents with chronic mechanical low back pain, obesity (BMI 31), and poor core strength. Her job requires prolonged sitting. A personalized treatment plan includes:

  • Chiropractic adjustments to the lumbar and thoracic spine
  • Dietary counseling to reduce inflammatory load
  • Calisthenic regimen of:
    • Bird-dogs for stabilization
    • Wall sits for quadriceps activation
    • Daily pelvic tilts to train lumbar control

Within 8 weeks, she reports reduced pain (VAS score from 7 to 3), improved posture, and increased daily movement tolerance.

Final Thoughts: Empowering Movement for Long-Term Health

Movement is medicine—particularly when it’s accessible, functional, and patient-led.

Calisthenics combined with chiropractic care offers a powerful, evidence-based approach to treating musculoskeletal disorders. This integrative strategy not only alleviates pain but also addresses the underlying biomechanical dysfunctions that contribute to chronic conditions. As a nurse practitioner practicing at the intersection of functional medicine and physical rehabilitation, I’ve seen firsthand how this combination can restore vitality, independence, and resilience in patients of all ages.

By embracing calisthenics as a therapeutic modality—and not just a fitness trend—we enable patients to become active participants in their healing journey. Whether managing chronic back pain, recovering from injury, or optimizing performance, bodyweight movement is one of the most effective and sustainable tools we can offer.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals with musculoskeletal disorders affecting their daily routines. When asking important questions to our associated medical providers, we advise patients to incorporate exercises like calisthenics to help reengage the musculoskeletal system while reducing muscle pain within the lumbar region. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Bellissimo, G. F., Ducharme, J., Mang, Z., Millender, D., Smith, J., Stork, M. J., Little, J. P., Deyhle, M. R., Gibson, A. L., de Castro Magalhaes, F., & Amorim, F. (2022). The Acute Physiological and Perceptual Responses Between Bodyweight and Treadmill Running High-Intensity Interval Exercises. Front Physiol, 13, 824154. https://doi.org/10.3389/fphys.2022.824154

Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. https://doi.org/10.1016/j.bjpt.2020.06.003

Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J, 18(5), 866-879. https://doi.org/10.1016/j.spinee.2018.01.013

Mear, E., Gladwell, V. F., & Pethick, J. (2022). The Effect of Breaking Up Sedentary Time with Calisthenics on Neuromuscular Function: A Preliminary Study. Int J Environ Res Public Health, 19(21). https://doi.org/10.3390/ijerph192114597

Osuka, Y., Kojima, N., Sasai, H., Ohara, Y., Watanabe, Y., Hirano, H., & Kim, H. (2020). Exercise Types and the Risk of Developing Cognitive Decline in Older Women: A Prospective Study. J Alzheimers Dis, 77(4), 1733-1742. https://doi.org/10.3233/JAD-200867

Zemkova, E., & Zapletalova, L. (2022). The Role of Neuromuscular Control of Postural and Core Stability in Functional Movement and Athlete Performance. Front Physiol, 13, 796097. https://doi.org/10.3389/fphys.2022.796097

Disclaimer

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises , , , , , , , , , , , , , , , ,

Pregnancy Indoor Cycling: Stay Active and Strong

During pregnancy, is indoor cycling a safe and recommended way to maintain fitness?

Pregnancy Indoor Cycling

Exercising during pregnancy is highly recommended for both the parent and the baby. Staying physically active can:

  • Increase blood circulation
  • Increase energy
  • Reduce backaches
  • Improve digestion and sleep
  • Enhance mood
  • Help manage weight
  • Promote muscle tone, strength, and endurance. (Hinman, S. K. et al., 2015)

The American College of Obstetricians and Gynecologists, or ACOG, advises pregnant individuals to exercise regularly during pregnancy. (The American College of Obstetricians and Gynecologists, 2024) The guidelines indicate that individuals who regularly engage in vigorous-intensity aerobic exercise before pregnancy should continue these activities during their pregnancy. (Syed H., Slayman T., & DuChene Thoma K. 2021) According to ACOG, observational studies of pregnant individuals who exercise show benefits such as:

  • The reduced risk of gestational diabetes mellitus
  • Cesarean birth
  • Operative vaginal delivery
  • Reduced postpartum recovery time
  • Exercise can also help prevent postpartum depression. (Syed H., Slayman T., & DuChene Thoma K. 2021)

Stationary cycling has been extensively studied in pregnancy and found safe and beneficial (American College of Obstetricians and Gynecologists, 2024).

Safety

Indoor cycling is ideal because individuals won’t have to deal with balance challenges or generate a heavy impact on their joints. There are many indoor cycling workouts to try, whether spin or on-demand classes. Indoor cycling is safer during pregnancy than outdoor cycling, which is not recommended because of the risk of falls from traffic and weather conditions. Although indoor cycling is generally considered safe during pregnancy, individuals should get clearance from their OB/GYN if they have any underlying medical conditions that might limit physical activity options.

Cycling Classes

Taking cycling classes during pregnancy is safe if a healthcare provider has no concerns. It’s important to take precautions.

  • It’s recommended to continue with any exercise you were doing before pregnancy rather than start a new routine.
  • Remember that this is an exercise for two, so the heart rate will elevate quickly and become overheated more easily.
  • Take it easier on the bike, and don’t push too hard.

Consult With the Instructor

It’s recommended to seek out an instructor with some prenatal exercise training. Individuals may benefit from sticking with the same instructor whenever possible to get to know them and familiarize themselves with their modifications and needs. Whether or not you’re showing, tell the instructor that you’re pregnant before the class starts. This way, they can monitor progress and will not push too hard. The instructor can also give important pointers on modifying the ride to suit your needs.

Modify Bike Set-Up

Individuals may need to adjust the saddle position and raise the handlebars to stay comfortable as their bodies change. Sitting more upright is recommended to relieve strain on the lower back, and increasing the handlebars and bringing them closer instead of leaning forward is another goal. Another goal is to keep the weight more evenly distributed between the hands and body. Also, avoid movable indoor bikes that mimic outdoor riding. They can lean sideways, which might cause a fall.

Dial Down Intensity

With indoor cycling, it’s best to exercise moderately during pregnancy. Consider wearing a heart rate monitor to ensure a safe intensity. It’s also helpful to pay attention to the Rating of Perceived Exertion scale/RPE. Even if the heart rate isn’t too high, slow down or stop exercising immediately if you’re gasping for breath or feeling lightheaded. ACOG guidelines indicate that 13-14 “somewhat hard” on the Borg RPE scale is a safe and acceptable level of exertion. The guidelines also state that RPE is a better gauge of exertion than heart rate and that the talk test (holding a conversation while exercising) can indicate safe workout intensity.

Stay Cool and Properly Hydrated

Wear comfortable, breathable clothing to help you stay cool and a bra with plenty of support. Drink lots of water throughout the workout, actually more than usual. Overheating and dehydration are common during pregnancy and can be dangerous for both parents and babies. Carrying an extra 20 to 30 pounds and having 40% more blood pumping through the body toward the end of pregnancy makes you likely to sweat more and can easily lead to dehydration. Using a fan for home gyms is highly recommended.

Avoid Standing and Stay In a Seated Position

During the early months, you may be able to ride in a standing position without any problems. But as the belly grows, it changes the body’s center of gravity, putting more pressure on the joints and making it difficult to ride standing. Joints are looser or more flexible during pregnancy, which makes standing while cycling more difficult and risky. It is still a healthy workout if you stay seated the whole time—and, most importantly, avoid overdoing it or injuring yourself.

Body Signs

Listen to the body while exercising. If you get winded, dizzy, or unwell while riding, take a break or reduce your effort by a few notches. If a 45-to-60-minute class is too intense, feel free to depart early; just let the instructor know you’re OK. Energy will likely ebb and flow during pregnancy, so pay attention to the body’s signals and take care of them accordingly. Stop exercising if you experience any of the following (Syed H., Slayman T., & DuChene Thoma K. 2021)

  • Abdominal pain
  • Dyspnea: shortness of breath before exertion
  • Headache
  • Dizziness
  • Calf pain or swelling
  • Muscle weakness affects balance
  • Chest pain
  • Amniotic fluid leakage
  • Regular painful contractions
  • Vaginal bleeding

Call your doctor if you experience sharp pain, contractions, a surge of fluid, a sudden severe headache, prolonged swelling, or decreased baby movement.

Injury Medical Chiropractic & Functional Medicine Clinic

It’s important to exercise wisely during the nine months to accommodate body changes, the extra weight, the increasingly relaxed ligaments, and the shift in the center of gravity. The stationary bike provides a personalized, low-impact workout. You get to control the intensity and the duration of the ride. Monitor your heart rate and/or RPE to avoid overdoing it. 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 Lower Back Pain Pregnancy Treatment

References

Hinman, S. K., Smith, K. B., Quillen, D. M., & Smith, M. S. (2015). Exercise in Pregnancy: A Clinical Review. Sports Health, 7(6), 527–531. https://doi.org/10.1177/1941738115599358

The American College of Obstetricians and Gynecologists. (2024). Exercise during pregnancy. https://www.acog.org/womens-health/faqs/exercise-during-pregnancy?utm_source=redirect&utm_medium=web&utm_campaign=int

Syed, H., Slayman, T., & DuChene Thoma, K. (2021). ACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstetrics and gynecology, 137(2), 375–376. https://doi.org/10.1097/AOG.0000000000004266

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises, Sleep Hygiene , , , , , , , , , , , , , , , , , ,

Exercising Before Bed: Impact on Your Sleep Cycle

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

Exercising Before Bed

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

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

Advantages

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

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

Disadvantages

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

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

Recommended Types of Exercise

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

Restorative Yoga

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

Tai Chi

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

Slow Walking

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

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

Exercises to Avoid

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

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

Working Out In The Evening

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

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

How Long After Working Out to Go To Sleep?

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

Injury Medical Chiropractic & Functional Medicine Clinic

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

Optimizing Your Wellness

References

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

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

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

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

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

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

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

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises, Sporting , , , , , , , , , , , , , , , , , , ,

Hula Hoop Workouts and Their Health Benefits

Can hula hooping be an option for individuals and athletes needing an effective, light, fun workout?

Hula Hoop Benefits for Core and Full Body Fitness

Hula Hoop Workout

A hula hoop workout is a low-impact exercise that involves spinning a hula hoop around your body. It can help improve balance, core strength, and aerobic fitness. Hula hooping is a great aerobic exercise that raises the heart rate and engages the whole body. Exercises can be done with a weighted or non-weighted hula hoop. A standard hoop will increase heart rate after about three minutes. A weighted hula hoop can target and build important core and lower body muscles, including the hamstrings, calves, quadriceps, and glutes. Lifting the weighted hula hoop also works the upper body muscles, giving the all-over body workout.

Weighted Hula Hoop

A weighted hula hoop can offer several health benefits.

Burns Calories

According to a research study, hula hooping can burn an average of 200 calories during a 30-minute workout. Researchers found that hooping is comparable in calories burned to boot camp-style fitness classes, kickboxing, and step aerobics. The average heart rate of the study participants was 151 beats per minute, equal to 84% of the age-predicted heart rate maximum. This can result in improved cardiovascular health and muscle conditioning. (American Council on Exercise, 2011)

Helps Build Muscle Mass

A study found that hula hooping increased trunk muscle mass and decreased waist circumference more than walking alone. Participants hula hooped an average of 12.8 minutes daily and walked almost 10,000 steps daily. The results showed more benefits to the core with hula hooping. The body fat percentage in the core region decreased significantly with hula hooping compared to walking. (Lahelma M. et al., 2019)

Lowers LDL Cholesterol

  • In the same study, researchers found that hula hooping can reduce LDL cholesterol more than walking. The results demonstrated an LDL-lowering effect similar to what resistance training does for cholesterol levels. Hula hooping for 13 minutes daily could benefit anyone with elevated cholesterol levels. (Lahelma M. et al., 2019)

Fun Workout

  • Weighted hula hooping can help individuals get out of a workout rut if they’re bored with a routine. It is recommended as either a warmup or a full workout.

Allows for Multitasking

  • If time to work out is limited, you can multitask using a hula hoop, easily add it to an exercise routine, and get moving while speaking on the phone, during breaks, or watching TV.

Benefits

  • Core strength: The exercise requires core strength to keep the hoop spinning.
  • Balance: Helps improve balance.
  • Aerobic fitness: Hooping can be used as a primary cardio routine.
  • Weight loss: Hooping can help burn calories and contribute to weight loss.

Hula Hoop Workout

  • Stand with a straight spine and feet shoulder-width apart.
  • Draw your abdomen in to engage your core.
  • Place the hoop around your waist, just above your hips.
  • Hold the hoop with both hands and toss it to one side.
  • Keep your back straight and move forward and back as fast as you can.
  • Pulse your hips and feet in a rocking motion.
  • Keep your arms out to the side or above your head.
  • Be mindful of posture, which will help you hoop better.

Weighted Workout

A full-weighted hula hoop workout. Start with a warmup for 5 minutes with a light jog or running in place. Then, perform three sets of the following:

Minute 1

  • 50 seconds of a hula hoop halo with the right arm – swinging the hoop around your arm
  • 10 seconds of rest

Minute 2

  • 50 seconds of a hula hoop halo with the left arm
  • 10 seconds of rest

Minute 3

  • 50 seconds around the waist, hula hooping
  • 10 seconds of rest

Minute 4

  • 50 seconds of hula hoop squats, keeping the hoop around the legs and not dropping it
  • 10 seconds of rest

Minute 5

  • 50 seconds of hula hoop sit-ups, keeping the hoop around your legs and not dropping it
  • 10 seconds of rest

Minute 6

  • 0 seconds of hula jumping front to back, keeping the hoop around your legs and not dropping it
  • 10 seconds of rest

How long you hula hoop each day is a matter of personal preference. To gain cardiovascular benefits, it is recommended that adults engage in at least 150 minutes per week of moderate-intensity aerobic activity. Spreading out the exercise throughout the week is preferable. (American Heart Association, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. 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.

Can Core Exercises Help With Back Pain?

References

American Council on Exercise. (2011). ACE-sponsored research: Hooping—Effective workout or child’s play? https://www.acefitness.org/certifiednewsarticle/1094/ace-sponsored-research-hooping-effective-workout-or-child-s-play/

Lahelma, M., Sädevirta, S., Lallukka-Brück, S., Sevastianova, K., Mustelin, L., Gylling, H., Rockette-Wagner, B., Kriska, A. M., & Yki-Järvinen, H. (2019). Effects of Weighted Hula-Hooping Compared to Walking on Abdominal Fat, Trunk Muscularity, and Metabolic Parameters in Overweight Subjects: A Randomized Controlled Study. Obesity facts, 12(4), 385–396. https://doi.org/10.1159/000500572

American Heart Association. (2024). American Heart Association Recommendations for Physical Activity in Adults and Kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises, Sporting , , , , , , , , , , , , , , , , , , ,

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

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises, Sleep Hygiene , , , , , , , , , , , , , , , , ,

Weight Resistance Training and Its Impact on Sleep Quality

For individuals looking to improve sleep, could weight training be the answer to increase healthy sleep?

Weight Resistance Training

Researchers found that resistance weight training improves sleep quality, among other methods like diet and sleep hygiene practices. Resistance training may improve sleep by reducing anxiety and stress, benefiting heart health, and promoting muscle recovery. Researchers examined non-medication methods of improving sleep in younger and middle-aged adults, comparing exercise, diet, and sleep hygiene practices. The findings showed that for adults under 65, resistance training is the best non-pharmacological way to improve sleep quality. (Hirohama, K. et al., 2024) These findings reinforce that sleep and exercise lead to improved restful sleep. Resistance training is highly effective compared to aerobic exercise (running or cycling) in improving sleep quality. The research shows that resistance exercise has more profound benefits than aerobic training alone.

Resistance Training and Improved Sleep

Resistance training, also called strength training or weight training, is intended to build muscle and strength using resistance. This can include:

  • Your body weight
  • Resistance bands
  • Free weights
  • Weight-lifting machines

The mechanisms by which exercise alters sleep are unknown. However, the researchers point out that weight training may improve sleep by improving mental health issues such as anxiety and depression. (Cunningham J. E. A., & Shapiro C. M. 2018) (Carbone E. A. et al., 2023) Other research on resistance training and sleep found that resistance training helped decrease anxiety and stress. (Alley J. R. et al., 2015) Resistance training can benefit heart health as it increases blood circulation. This means the heart’s vessels don’t have to work as hard during sleep when blood pressure should naturally drop, which is known as nocturnal dipping, which is great for individuals with high blood pressure.

Another reason this training may help with sleep is its impact on the body. Previous research on resistance training and sleep suggests that since weight training stresses muscle tissue, it could signal the brain that sleep is needed to repair the damage (Iowa State University, 2022). The hormone adenosine, which helps promote sleep, is a key factor in why exercise increases adenosine levels and helps the body doze off. (Roig M. et al., 2022)

How Much Resistance Training Is Needed?

Sleep doctors advise patients to perform some form of daily movement or exercise to improve sleep. The amount of resistance training an individual needs depends on their circumstances, such as underlying conditions, injuries, fitness level, physical ability, and time.

  • General guidelines from the American Heart Association recommend strength training at least twice a week.
  • The guidelines for physical activity from the Department of Health and Human Services recommend adults do a muscle-strengthening activity at least two days each week in addition to at least 150 to 300 minutes of moderate-intensity aerobic activity.
  • The meta-analysis research found that a 55-minute resistance training session consisting of three sets of 10 to 12 exercises done three times a week positively affected sleep quality.
  • They added that higher intensity and frequency of training could have a greater effect on sleep.

In other research on exercise and sleep, study participants were grouped into resistance training, aerobic, and combination workouts – both resistance and aerobic exercise. Each group engaged in 60-minute training sessions three times a week, with the combination group doing 30 minutes of resistance training and 30 minutes of aerobic exercise each session. (Iowa State University, 2022) Resistance training increased sleep by an average of 40 minutes compared to about 23 minutes for those who did an hour of aerobic exercise. A combination of aerobic and resistance increased sleep by about 17 minutes. (American Heart Association, 2022)

Previous research on resistance training and sleep found that exercise at any time can improve sleep quality compared with no strength training. However, evening sessions tend to help individuals sleep a little better. (Alley J. R. et al., 2015) Resistance exercise may offer benefits regarding the ability to fall asleep and stay asleep for those with osteoporosis, sarcopenia, anxiety, or depression.

Strength Workouts

Resistance training that targets all the major muscle groups is the goal. The Iowa State University research had participants use 12 resistance machines to perform exercises, including: 

  • Leg presses
  • Chest presses
  • Lat pulldowns
  • Bicep curls
  • Abdominal crunches 
  • Participants performed three sets of eight to 12 reps at 50% to 80% of their one-rep max. (Iowa State University, 2022)
  • One of the studies had participants work out for 30 minutes using nine different resistance machines, completing three sets of 10 reps. (Alley J. R. et al., 2015)

However, individuals can also use dumbbells such as bicep curls or chest presses, barbells for deadlifts or back squats, resistance bands for lateral shoulder raises or leg extensions, or their body weight for movements such as chin-ups or push-ups.

Other Ways to Improve Sleep Without Meds

Other non-drug methods to improve sleep include a healthy diet, proper hydration, dietary changes, and stress management like meditation. Aerobic exercise is known to improve both sleep quantity and quality. (Kovacevic A. et al., 2018) Lifestyle behaviors outside exercise are also important for sleep. Sleep hygiene refers to having healthy sleep habits and behaviors at night. This includes optimizing pre-bedtime routines to prepare the mind and body for sleep and improving bedroom environments to ensure sleep support, meaning it is cool, dark, quiet, and free from distractions like phones. Another important method of improving sleep is listening to your body and not forcing yourself to stay up late when exhausted. Pushing the brain and body to stay up later leads to chronic sleep debt. Eating sugary and high-fat foods before bed can hinder sleep patterns. Drinking caffeine after dinner or close to bedtime can disrupt the sleep cycle, as well as alcohol consumption before bed can hurt sleep quality.

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals need rest time to adjust to working out, so consult a doctor on the balance of rest and training. 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.

Weight Loss Techniques

References

Hirohama, K., Imura, T., Hori, T., Deguchi, N., Mitsutake, T., & Tanaka, R. (2024). The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PloS one, 19(6), e0301616. https://doi.org/10.1371/journal.pone.0301616

Cunningham, J. E. A., & Shapiro, C. M. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, 1–12. https://doi.org/10.1016/j.jpsychores.2017.12.012

Carbone, E. A., Menculini, G., de Filippis, R., D’Angelo, M., De Fazio, P., Tortorella, A., & Steardo, L., Jr (2023). Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. International journal of environmental research and public health, 20(5), 4431. https://doi.org/10.3390/ijerph20054431

Alley, J. R., Mazzochi, J. W., Smith, C. J., Morris, D. M., & Collier, S. R. (2015). Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. Journal of strength and conditioning research, 29(5), 1378–1385. https://doi.org/10.1519/JSC.0000000000000750

Iowa State University. (2022). Pumping iron may improve sleep more than cardio workouts. https://www.news.iastate.edu/news/2022/03/03/resistance-exercise-sleep

Roig, M., Cristini, J., Parwanta, Z., Ayotte, B., Rodrigues, L., de Las Heras, B., Nepveu, J. F., Huber, R., Carrier, J., Steib, S., Youngstedt, S. D., & Wright, D. L. (2022). Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory. Exercise and Sport Sciences Reviews, 50(1), 38–48. https://doi.org/10.1249/JES.0000000000000273

American Heart Association. (2022). Resistance exercise may improve sleep more than aerobic exercise. https://www.heart.org/en/news/2022/03/03/resistance-exercise-may-improve-sleep-more-than-aerobic-exercise#:~:text=The%20results%20are%20considered%20preliminary,at%20night%2C%22%20Brellenthin%20said.

Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews, 39, 52–68. https://doi.org/10.1016/j.smrv.2017.07.002

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Chiropractic Care, Exercises , , , , , , , , , , , , , , , , , ,

The Benefits of Standing Lower Back Flexion for Pain Management

Could incorporating standing lumbar flexion exercise into a daily routine help decrease pain and improve overall spinal mobility for individuals with low back pain?

Standing Lower Back Flexion Exercise

A chiropractic physical therapy team visit can help determine which exercises are best for an individual’s injury or condition and teach them what to stop doing if they have low back pain. Exercise and proper posture can decrease discomfort and improve mobility for individuals with low back pain. (Suh, J. H. et al., 2019) Sometimes, exercises that bend backward are recommended, while other times, flexion or forward bending movements are the best way to manage lower back pain. Many find the standing Williams lumbar flexion exercises maneuver helpful for low back pain. (Amila A, Syapitri H, Sembiring E. 2021)

Benefits

Individuals with certain diagnoses may benefit from spinal flexion. These diagnoses include:

Be sure to speak with a healthcare provider to understand the diagnosis and low back symptoms, and work with a physical therapist to be sure that forward flexion of the spine is the correct exercise for your back.

When To Avoid Lumbar Flexion

Some should avoid excessive forward bending, which could cause further damage or injury to the spine. Reasons to avoid flexion include:

Before starting this or any other exercise program for your spine, check with a healthcare provider or physical therapist.

How to Perform

Gradually progressing with other gentle lumbar flexion exercises before full-standing lumbar flexion is recommended. These include performing a week or two of lumbar flexion lying down, followed by a couple weeks of lumbar flexion seated. Once these exercises are easy to perform and pain-free, progress with lumbar flexion standing postures.​To perform, follow these steps:

  • Stand with your feet shoulder-width apart.
  • Slowly bend forward by sliding your hands down the front of your thighs.
  • Reach down as far as possible and let your lower back bend forward.
  • Grab your ankles and gently pull into more forward flexion to increase the backstretch.
  • Hold the end position for a second or two, then slowly return to the starting position.

As you exercise, be sure to monitor changes in symptoms. Pain worsening in the back or traveling down your leg indicates that you should stop the exercise (Spine-health, 2017). If the pain decreases in your leg or centralizes to your back, continue the exercise. Standing lumbar flexion can be repeated for 10 repetitions a couple of times daily. It can help decrease low back or leg pain symptoms and stretch tight hamstrings and back muscles. (Montefiore Pediatric Orthopedic and Scoliosis Center, 2003)

Injury Medical Chiropractic and Functional Medicine Clinic

Exercise can also prevent future lower back problems. Standing back flexion, postural correction, regular physical activity, and exercise are tools for keeping the spine healthy. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

What Causes Disc Herniation?

References

Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173

Amila A, Syapitri H, Sembiring E. (2021). The effect of William Flexion Exercise on reducing pain intensity for elderly with low back pain. Int J Nurs Health Serv., 4(1), 28-36. https://doi.org/https://doi.org/10.35654/ijnhs.v4i1.374

Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. https://doi.org/10.1136/bmj.h6234

Sfeir, J. G., Drake, M. T., Sonawane, V. J., & Sinaki, M. (2018). Vertebral compression fractures associated with yoga: a case series. European journal of physical and rehabilitation medicine, 54(6), 947–951. https://doi.org/10.23736/S1973-9087.18.05034-7

Howell E. R. (2012). Conservative management of a 31 year old male with left sided low back and leg pain: a case report. The Journal of the Canadian Chiropractic Association, 56(3), 225–232.

Spine-health. (2017). Exercise with lower back pain: Should you work through the pain? Spine-health
Knowledge from Veritas. https://www.spine-health.com/blog/exercising-lower-back-pain-should-you-work-through-pain

Montefiore Pediatric Orthopedic and Scoliosis Center. Center, M. P. O. a. S. (2003). Low Back Strain. https://www.cham.org/File%20Library/Global%20Navigation/Expertise%20And%20Programs/Pediatric%20Expertise/Orthopedics/Monte-LOW-BACK-STRAIN-WITH-EXERCISES.pdf

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Exercises, Sporting , , , , , , , , , , , , , , , , , , ,

How to Properly Warm Up Before Running

Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?

Warming Up, Cooling Down

Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.

Steps for a Running Warmup

  • Do five to 10 minutes of light aerobic exercise to loosen up muscles.
  • Walk briskly, march, jog slowly, or cycle on a stationary bike.
  • Don’t rush.
  • Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
  • Begin the run with a slow jog and gradually increase speed.
  • Slow down if you run out of breath.
  • This is part of knowing how fast you should run; starting too fast is a common mistake.
  • Pay attention to posture and form.
  • Ensure you are using the best technique before speeding up.

Warm Up Benefits

When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)

Properly Cooling Down

At the end of the run:

  • Cool down by walking or slowly jogging for five to 10 minutes.
  • Breathing and heart rate should gradually return to normal.
  • Drink water or an electrolyte-infused drink to rehydrate the body.

Benefits of a Cooldown

The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.

Before or After Stretching 

Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)

Stretching After Running

Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:

Don’t Bounce

  • Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
  • Hold the stretch for 15 to 30 seconds.

Don’t Stretch Through Pain

  • Don’t stretch beyond the point where tightness is felt in the muscle.
  • Do not push through muscle resistance.
  • Never stretch to the point of pain.

Stretch Whole Body

  • Don’t just stretch the areas with tightness and/or soreness.
  • Stretch the whole body equally to prevent injury.

Don’t Hold Your Breath

  • Take deep breaths during the stretch.
  • Stay relaxed and breathe in and out slowly.

If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises. 

Injury Medical Chiropractic and Functional Medicine Clinic

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

The Science of Motion

References

The American Heart Association. (2024). Warm up, cool down. https://www.heart.org/en/healthy-living/fitness/fitness-basics/warm-up-cool-down

Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. https://doi.org/10.1002/14651858.CD004577.pub3

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. https://doi.org/10.1007/s40279-018-0916-2

By Dr. Alexander Jimenez DC, APRN, FNP-C 0 Comments Chiropractic Care, Sporting , , , , , , , , , , , , , , , , ,

Key Exercises in the Treatment of Achilles Tendonitis: A Protocol

Can incorporating an exercise program like the Alfredson Protocol help athletes and individuals who have hurt their Achilles tendon find pain relief and healing so they can return to regular physical activities?

Exercise Protocol Achilles Tendonitis

Achilles tendonitis occurs when the tendon at the back of the ankle gets injured. It is common in runners. For individuals who have Achilles tendonitis, walking and running can be painful. You might have to stop engaging in exercise and physical activities like sports. Depending on your job, having the condition may make working harder. Here are a few of the signs and symptoms of the condition:

  • Pain in the back of the lower leg, just above the heel.
  • Pain with running, jumping, or pointing the toes.
  • A small lump on the Achilles tendon just above the heel.

The first line of treatment is to rest and ice the tendon. Anti-inflammatory medications can help reduce pain. (American Academy of Orthopaedic Surgeons, 2022) Physical therapy can include strengthening exercises, ultrasound heat therapy, and deep massage. Exercises stretching the nearby muscles will help gradually increase the stress the tendon can handle, eventually reducing inflammation and swelling. Stretching and flexibility exercises will help an Achilles tendon heal. (University of Michigan, 2023)

The only way to determine if an individual has injured their Achilles tendon is to see a doctor. If the injury is Achilles tendonitis, a physical therapist may be recommended. A physical therapist can train individuals on the Alfredson protocol, an exercise protocol program for those with Achilles tendonitis (tendinopathy) that research has shown is helpful for those with the condition. The therapist will train on how to exercise to strengthen the tendon. The exercises stretch the Achilles tendon to help it handle forces and stress, known as eccentric loading. (Stevens M., & Tan C. W. 2014)

Inflammation

Tendonitis is inflammation of a tendon. However, studies have shown that the tendon might not be inflamed in those with the condition. When an area of the body is inflamed, inflammatory cells are present. Individuals usually feel pain in the inflamed area. For those with Achilles tendonitis, the tendon will present with pain, but not necessarily because the tendon is inflamed. Under a microscope, researchers examined tissue from the tendons of those with Achilles tendonitis. They did not find inflammatory cells in the tissue. (Stevens M., & Tan C. W. 2014) This means that although individuals felt pain, they were not inflamed. If there are no inflammatory cells in the tendon, this could explain why those with Achilles tendonitis often do not find relief from the anti-inflammatory treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Studies have shown that gentle exercise protocols for the tendon are more helpful. However, researchers are not sure why these exercises are so beneficial. (O’Neill S., Watson P. J., & Barry S. 2015)

Eccentric Exercise

A chiropractic physical therapy team can help individuals heal the injury with eccentric loading exercises. Eccentric loading exercises work the muscles and tendons to help them get stronger. Once healing has begun, they can help strengthen the tendon. Individuals start slowly with easy exercises and then work up to harder ones. They will have the patient lengthen or stretch out the muscle. As the patient moves, the muscles and tendons contract or shorten. The Alfredson protocol consists of eccentric loading exercises for the Achilles and the muscles that support it.

Alfredson Protocol

Before exercising, talk to a doctor or physical therapist to know if it’s safe. How to do the Alfredson protocol:

  1. First, stand on a small step or curb.
  2. Stand with the balls of your feet on the edge.
  3. Your heels should hang over the edge.
  4. Hold onto something for balance.
  5. Keep the knees straight.
  6. This will load a muscle part of the Achilles tendon called the gastrocnemius.
  7. Using both feet, lift the heels and rise onto the balls of the feet.
  8. Keep the foot with the painful Achilles tendon on the step.
  9. Lift the non-injured foot off the step.
  10. Slowly lower down using the injured ankle.
  11. The heel should move towards the floor.
  12. The ball of the foot should remain in contact with the edge of the step.
  13. Return the non-injured foot to the step.
  14. Repeat the exercise.

Do three sets of 15 reps with the knees straight. Then, do the Alfredson protocol again with the knees slightly bent. This will work a muscle called the soleus, which connects to the gastrocnemius. Perform three sets of 15 repetitions. Perform both exercises twice a day. This could be in the morning and the evening. The Alfredson protocol is most beneficial when done for about 12 weeks. (Stevens M., & Tan C. W. 2014)

Injury Medical Chiropractic and Functional Medicine Clinic

The Alfredson exercise protocol can be done at home with a step or raised platform to put the feet on safely. Individuals should consider working with a personal trainer to ensure safety and get the most out of the workouts. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Functional Foot Orthotics Achieve Optimal Performance

References

American Academy of Orthopaedic Surgeons. OrthoInfo. (2022). Achilles Tendinitis. https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

University of Michigan. (2023). Achilles Tendon Injury: Physical Therapy and Rehab. https://www.uofmhealth.org/health-library/tr2261

Stevens, M., & Tan, C. W. (2014). Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial. The Journal of orthopaedic and sports physical therapy, 44(2), 59–67. https://doi.org/10.2519/jospt.2014.4720

O’Neill, S., Watson, P. J., & Barry, S. (2015). WHY ARE ECCENTRIC EXERCISES EFFECTIVE FOR ACHILLES TENDINOPATHY?. International journal of sports physical therapy, 10(4), 552–562.