Can postural assessments help identify problems with how a person stands or sits, which can lead to various musculoskeletal issues?
Postural Assessment
Proper posture is an exercise in which the muscles support the skeleton in a comfortable, stable, and efficient alignment. Healthy posture is present when the body is still and when moving. However, numerous factors can affect and hinder posture. These include daily wear and tear, injury, illness, or a condition. A posture assessment is a process that identifies posture issues and their root causes, often using visual and palpation techniques, and can help determine appropriate treatment or exercises. (Science Direct, 2007)
Visual Assessment
Observing the body’s alignment and symmetry from different angles (anterior, posterior, and lateral views).
Consider their daily activities, work environment, and any previous injuries. (Du, S. H. et al., 2023)
Wall Test
The patient stands against a wall with their feet shoulder-width apart and heels about 6 inches from the baseboard.
If they have good posture, their ears will be vertically aligned with their shoulders, and their head will be no more than three finger widths from the wall. (Physiopedia, 2025)
Professionals Who Can Perform a Posture Assessment
Physiotherapists
Professionals trained in assessing and treating musculoskeletal problems.
Chiropractors
Professionals who focus on the spine and nervous system.
Fitness Professionals
Personal trainers or other fitness professionals can use posture assessments to help clients improve their posture and movement.
Ergonomists
Professionals who specialize in designing workspaces and environments to promote good posture and reduce strain.
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.
Singla, D., & Veqar, Z. (2014). Methods of postural assessment used for sports persons. Journal of clinical and diagnostic research: JCDR, 8(4), LE01–LE4. https://doi.org/10.7860/JCDR/2014/6836.4266
Du, S. H., Zhang, Y. H., Yang, Q. H., Wang, Y. C., Fang, Y., & Wang, X. Q. (2023). Spinal posture assessment and low back pain. EFORT open reviews, 8(9), 708–718. https://doi.org/10.1530/EOR-23-0025
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:
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
Uncover the health benefits of tofu. This nutritious ingredient is great for both your taste buds and your well-being.
Introduction
As a nurse practitioner with over two decades of clinical experience in physical and functional medicine, I’ve witnessed firsthand the transformative power of food as medicine. In particular, the role of plant-based proteins like tofu has grown increasingly significant in evidence-based interventions aimed at reducing cardiovascular risk.
From managing hypertension and dyslipidemia to reducing systemic inflammation, a heart-healthy diet is one of the most accessible and sustainable lifestyle changes patients can make. One often-underappreciated food with robust cardioprotective properties is tofu. In this article, we’ll explore the science-backed benefits of tofu, its role in functional cardiovascular care, and practical ways to integrate it into a heart-smart diet.
Why Functional Nutrition Matters for Cardiovascular Health
The heart doesn’t function in isolation—it works in concert with every other system in the body. Functional medicine recognizes that cardiovascular issues often stem from a constellation of root causes: chronic inflammation, oxidative stress, hormonal imbalances, dysregulated blood sugar, and nutrient deficiencies, just to name a few.
Rather than isolating nutrients or treating lab values in a vacuum, functional nutrition focuses on synergy—how whole foods interact with body systems to optimize health. Tofu, with its impressive nutrient density and anti-inflammatory profile, fits seamlessly into this paradigm.
What Is Tofu? A Nutritional Powerhouse from the Soybean
Tofu, also known as bean curd, is a protein-rich food derived from soybeans. It has been a staple in East Asian diets for over 2,000 years and is gaining popularity in the West for good reason.
To produce tofu, soybeans are soaked, blended, and strained into a soy milk, which is then coagulated using calcium or magnesium salts and pressed into blocks. This process preserves the soybean’s rich content of protein, calcium, iron, and bioactive compounds.
Unlike ultra-processed meat substitutes, tofu is a minimally processed, whole food source of plant protein that aligns with the foundational principles of a heart-healthy, anti-inflammatory diet.
Nutritional Profile of Tofu (Per 116g Serving of Firm Tofu)
Calories: 88
Protein: 9g
Fat: 6g (mostly unsaturated)
Saturated Fat: 0.8g
Carbohydrates: 2.2g
Fiber: 0.3g
Sodium: 8mg
Potassium: 140mg
Iron: 34% Daily Value (DV)
Calcium: 40% DV
Magnesium: 8% DV
Vitamin B6: 5% DV
Tofu also contains all nine essential amino acids, making it a complete protein—an important consideration for those transitioning away from animal products.
The Healing Diet: Combat Inflammation & Embrace Wellness- Video
The Cardiovascular Benefits of Tofu: What the Science Says
1. Lowering LDL Cholesterol
A pivotal meta-analysis published in the Journal of Nutrition (Messina, 2016) confirmed the LDL-lowering effects of soy protein. Tofu, being rich in soy protein, can help reduce low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol. By displacing saturated fat and dietary cholesterol from animal proteins, tofu supports healthier lipid profiles.
2. Anti-Inflammatory and Antioxidant Properties
Tofu is rich in isoflavones, naturally occurring phytoestrogens found in soybeans. Isoflavones like genistein and daidzein have antioxidant properties and may inhibit inflammation at the endothelial level—critical for patients with atherosclerosis or at risk for coronary artery disease. According to Rizzo et al. (2023), these compounds help maintain vascular flexibility and may inhibit platelet aggregation, reducing clot risk.
3. Blood Pressure Regulation
Magnesium, potassium, and calcium—key electrolytes found in tofu—are all essential for regulating blood pressure. These nutrients support vascular tone and optimize endothelial function. Additionally, substituting animal-based protein with tofu helps reduce overall sodium intake, further supporting blood pressure goals.
4. Weight and Metabolic Control
With only 88 calories per serving and a high satiety value, tofu is a strategic food for weight management—an important factor in controlling cardiovascular risk. The protein-fiber-fat ratio makes it ideal for glycemic regulation and preventing insulin resistance.
5. Improved Lipid Profiles and Reduced Coronary Risk
Longitudinal studies have demonstrated that plant-based diets rich in soy protein improve HDL/LDL ratios and reduce triglycerides, especially when tofu is used to replace red meat or processed meats. According to Erdman (2000), soy-based interventions can reduce coronary heart disease risk by as much as 20% over time when combined with other healthy lifestyle changes.
Types of Tofu and Their Culinary Uses
Tofu’s versatility is one reason it’s so easy to integrate into a heart-healthy diet. Understanding its different textures can help patients and practitioners alike explore creative and satisfying meal planning.
Silken Tofu: Soft, custard-like texture. Excellent in smoothies, sauces, and desserts.
Soft Tofu: Slightly firmer than silken. Ideal for soups and gentle sautés.
Firm Tofu: Maintains structure well. Great for stir-fries, curries, and grilling.
Extra-Firm Tofu: Dense and chewy. Best for baking, frying, or as a meat substitute in hearty recipes.
Fermented Tofu: A flavorful condiment used in East Asian dishes. Contains probiotics and can support gut health.
Each form can be marinated, baked, crumbled, or pureed—making tofu a culinary chameleon and nutrient-rich addition to any cardiovascular prevention strategy.
Is Tofu a Reliable Protein Source for Cardiovascular Patients?
Yes—and not just for vegans or vegetarians. One of the biggest concerns in reducing animal protein intake is whether patients will meet their protein needs. Tofu alleviates this concern by offering a complete amino acid profile.
Furthermore, because tofu contains very little saturated fat and zero dietary cholesterol, it aligns with AHA (American Heart Association) guidelines for protein sources that support cardiac health. Tofu also promotes lean muscle maintenance, critical for older adults at risk for sarcopenia—a condition that compounds cardiovascular vulnerability.
Functional Medicine Tips: How to Add Tofu to a Heart-Healthy Diet
Transitioning to a more plant-based approach doesn’t have to be intimidating. Here are simple, evidence-informed ways to incorporate tofu:
Tofu Scrambles: Replace eggs with crumbled firm tofu, turmeric, and vegetables for a cholesterol-free breakfast.
Stir-Fries: Toss cubed tofu with olive oil, garlic, and cruciferous vegetables like broccoli or bok choy.
Tofu Bowls: Combine baked tofu with quinoa, avocado, leafy greens, and tahini for a nutrient-dense lunch.
Soups and Stews: Add soft tofu to miso or vegetable-based soups for added protein and satiety.
Smoothies: Blend silken tofu with berries, flaxseed, and almond milk for a protein-packed snack.
Marinated and Grilled: Let tofu absorb anti-inflammatory marinades (like ginger-garlic-tamari) before grilling.
Encourage patients to explore international cuisines—particularly Japanese, Korean, and Thai recipes—that have normalized tofu as a central protein source for centuries.
Addressing Common Concerns About Soy
Despite its benefits, soy has faced scrutiny—largely due to misconceptions around phytoestrogens. However, clinical research consistently shows that moderate soy intake is safe and beneficial for most populations, including breast cancer survivors and men with prostate concerns.
In fact, population studies in East Asia demonstrate lower rates of hormone-sensitive cancers and cardiovascular disease in populations consuming soy regularly. As with any food, balance and moderation are key.
Final Thoughts: Tofu as a Functional Ally for Cardiovascular Health
Tofu isn’t just a trend—it’s a time-tested, nutrient-dense, cardioprotective food with substantial clinical value. As healthcare providers, we should not underestimate the power of simple dietary substitutions. Replacing saturated fat-rich meats with plant-based proteins like tofu can reduce cardiovascular burden, support metabolic resilience, and enhance quality of life.
From a functional medicine lens, tofu exemplifies the concept of food as a therapeutic tool. Its ability to modulate inflammation, support endothelial function, and provide sustainable, complete protein makes it a cornerstone in any heart-healthy nutrition plan.
Injury Medical & Functional Medicine Clinic
We associate with certified medical providers who understand the importance of assessing individuals dealing with cardiovascular issues and are looking for natural alternatives to incorporate plant-based foods into a healthy diet. When asking important questions to our associated medical providers, we advise patients to incorporate tofu into their diet to reduce the effects of cardiovascular disorders related to the body. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Dang, Y., Ren, J., Guo, Y., Yang, Q., Liang, J., Li, R., Zhang, R., Yang, P., Gao, X., & Du, S. K. (2023). Structural, functional properties of protein and characteristics of tofu from small-seeded soybeans grown in the Loess Plateau of China. Food Chem X, 18, 100689. https://doi.org/10.1016/j.fochx.2023.100689
Erdman, J. W., Jr. (2000). AHA Science Advisory: Soy protein and cardiovascular disease: A statement for healthcare professionals from the Nutrition Committee of the AHA. Circulation, 102(20), 2555-2559. https://doi.org/10.1161/01.cir.102.20.2555
Eze, N. M., Okwume, U. G., Eseadi, C., Udenta, E. A., Onyeke, N. G., Ugwu, E. N., Akubue, B. N., Njoku, H. A., & Ezeanwu, A. B. (2018). Acceptability and consumption of tofu as a meat alternative among secondary school boarders in Enugu State, Nigeria: Implications for nutritional counseling and education. Medicine (Baltimore), 97(45), e13155. https://doi.org/10.1097/MD.0000000000013155
Messina, M. (2016). Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. Nutrients, 8(12). https://doi.org/10.3390/nu8120754
Rizzo, J., Min, M., Adnan, S., Afzal, N., Maloh, J., Chambers, C. J., Fam, V., & Sivamani, R. K. (2023). Soy Protein Containing Isoflavones Improves Facial Signs of Photoaging and Skin Hydration in Postmenopausal Women: Results of a Prospective Randomized Double-Blind Controlled Trial. Nutrients, 15(19). https://doi.org/10.3390/nu15194113
When you don’t have breadcrumbs or want to try something else, what are healthy substitutes for breadcrumbs that may yield similar results without sacrificing flavor or texture?
Bread Crumbs
Various recipes call for bread crumbs. Adding bread crumbs to sauces and other dishes helps bind and thicken wet ingredients while sprinkling bread crumbs on top of casseroles can add a crispy, crunchy texture. Individuals who follow low-carb or gluten-free meal plans or those with allergies to wheat may choose to avoid bread crumbs and dishes made with them. Wheat-free substitutes can replace bread crumbs in recipes with similar results, though the recipe may vary slightly.
Why Use Substitutes?
Individuals with food allergies or dietary restrictions may seek a substitute for bread crumbs since they may contain common allergens like wheat and gluten. Wheat is among the most common food allergies in the U.S. (Asthma and Allergy Foundation of America, 2022)
For those with allergies or sensitivities, gluten- and wheat-free bread crumbs are available to purchase at some stores, and some use alternatives out of preference. Crushing different varieties of chips, crackers, and pretzels can be used instead of bread crumbs, adding a unique flavor and texture. However, these substitutes may not be an option for recipes that call for bread crumbs to bind or thicken wet ingredients.
Bread products like bread crumbs can be part of a balanced diet. Guidelines recommend between 3 and 5 servings of whole grains daily for adults, including whole-wheat bread. (United States Department of Agriculture, 2025)
The main macronutrient in bread crumbs is carbohydrates.
Bread crumbs are usually consumed in small amounts because they are not the main ingredient.
Substitutes
Rolled Oats or Oat Flour
Oats and oat flour are often used as gluten-free alternatives to wheat in baking. Oats by weight are:
Lower in calories
Provide more complex carbohydrates.
They are a richer source of dietary fiber than bread crumbs.
Like regular flour, oats can be a binder in meat-based recipes. For example, if a recipe for meatloaf or meatballs calls for bread crumbs, rolled oats or oat flour can be successfully substituted.
Ensure the oats are gluten-free for individuals with gluten allergies, celiac, or gluten sensitivity. Though oats are inherently gluten-free, they may be processed on shared equipment and exposed to cross-contamination.
Cornflakes
Cornflakes can also add a crunchy texture to baked recipes. While corn is inherently gluten-free, cornflakes may not be. For individuals who have allergies or sensitivities, ensure you use gluten-free cornflakes. To use cornflakes, crunch them up by adding them to a ziplock bag and pressing them on the outside.
Nuts
Try nuts like almonds, walnuts, pecans, and cashews to add crunch and nutrients to a recipe. They are rich in healthy fats, protein, vitamins, and minerals. Plain nuts are also gluten-free, but roasted nuts may contain a wheat-based coating. Be sure to read the labels before using them.
Seeds
Seeds are a nutritious substitute.
They offer a different crispy, crunchy texture.
Shredded Coconut
Shredded or desiccated coconut can be used for sweet or rich recipes. It is perfect for adding to baked goods, especially gluten-free varieties. The recipe may need to be adjusted slightly because coconut has more moisture than regular bread crumbs. Do a small sample first to see how the coconut works in the recipe.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Hypertension? There’s a Diet for That
References
Asthma and Allergy Foundation of America. (2022). Food allergies. https://aafa.org/allergies/types-of-allergies/food-allergies/
United States Department of Agriculture, FoodData Central. (2018). Bread crumbs, dry, grated, plain. Retrieved from https://fdc.nal.usda.gov/food-details/174928/nutrients
United States Department of Agriculture. Dietary Guidelines for Americans 2020-2025. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf
Can understanding how leg cramps feel, their causes, and prevention help individuals with treatment options?
Leg Cramp Causes
A leg cramp is an involuntary contraction of the muscles in the leg, typically the calf muscle. It causes a sudden, sharp, and painful tightening of the muscle. They commonly occur from
Dehydration
Muscle overexertion
They can be a symptom of an underlying health condition, such as type 2 diabetes or kidney failure.
They can also be a side effect of certain medications.
Sensation
Leg cramps typically cause sudden, severe pain in the affected muscle. Individuals may also feel a hard knot or twitching of the muscle. The calf muscles are the most common site. (Harvard Health Publishing, 2024)
Causes
The underlying cause of leg cramps isn’t always known. However, work, lifestyle factors, and medical conditions can play a role. Common causes include:
Dialysis – treatment to remove excess fluid from the blood when kidneys fail.
Respiratory diseases of the lungs and airways
Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a neurological condition affecting the brain, nerves, and muscles)
Self-Care
Leg cramps often go away on their own after a few minutes. However, other self-care can help. Recommendations: (Harvard Health Publishing, 2024)
Change Body Positions
Moving can help relieve tension and pain.
If the leg cramps happen at night, stand up and take a few steps.
Massage
Gently rubbing the cramped muscle can help it relax.
Stretch
Stretching the cramping muscle can help it relax.
Apply Heat
If the leg cramp lasts more than a few minutes, apply a heating pad or take a warm shower to increase blood circulation to and around the muscle to help it relax.
Treatment
There are no medications specifically for treating leg cramps. However, if symptoms are caused by another medical condition, treating the underlying condition might help reduce cramp frequency. Dehydration or low electrolytes can cause leg cramps; in these cases, drinking water or electrolyte-infused beverages can help. If cramps are related to overexercising, consider reducing the intensity of your activity or exercising in a cooler environment. (Maughan R. J. & Shirreffs S. M. 2019) Magnesium supplements are usually marketed to relieve muscle cramps; they are not proven to alleviate them. (Garrison, S. R. et al., 2020)
Exercises and Stretches
Knowing which muscle to target when stretching the leg is important. If the cramp does not resolve after the first stretch attempt, try again.
Place palms flat against the wall at shoulder height.
Step the cramping leg away from the wall around 12 to 18 inches.
Keep your heels flat on the floor.
Keeping the back leg straight, bend the front knee slowly and lean forward until you feel a stretch along the calf.
Hold for 30 to 60 seconds.
Prevention
They can’t always be prevented. However, if they are related to dehydration or other lifestyle factors, individuals may be able to prevent them from occurring or decrease the frequency. Try the following: (Harvard Health Publishing, 2024)
Drink plenty of water.
Stretch the leg muscles before you go to bed.
Try drinking a beverage with electrolytes for longer workouts or activities in hot weather.
Warm up before exercise, such as with a slow jog, before getting into more intense exercises.
Properly cool down after a workout.
Stretch the leg muscles before and after exercising.
Maintain a healthy body weight.
Contact a Healthcare Provider
Leg cramps can sometimes signify something more serious than a Charley horse. See a healthcare provider if any of the following symptoms present (National Library of Medicine, 2020)
Change in skin color, including redness or a deeper tone than normal
Cramps that last more than a few minutes or occur frequently
Muscle weakness
Severe pain from the cramps
Swelling
Warm skin
Injury Medical Chiropractic & Functional Medicine Clinic
Talk to a healthcare provider about leg cramps to learn what interventions would help the most. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Is Motion Key to Healing?
References
Harvard Health Publishing. (2024). How to get rid of muscle cramps in your legs. https://www.health.harvard.edu/pain/how-to-get-rid-of-muscle-cramps-in-your-legs
National Library of Medicine. (2020). Muscle cramps. Retrieved from https://medlineplus.gov/musclecramps.html
Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.), 49(Suppl 2), 115–124. https://doi.org/10.1007/s40279-019-01162-1
Garrison, S. R., Korownyk, C. S., Kolber, M. R., Allan, G. M., Musini, V. M., Sekhon, R. K., & Dugré, N. (2020). Magnesium for skeletal muscle cramps. The Cochrane database of systematic reviews, 9(9), CD009402. https://doi.org/10.1002/14651858.CD009402.pub3
American Academy of Orthopaedic Surgeons. (2018). Knee conditioning program. https://orthoinfo.aaos.org/en/recovery/knee-conditioning-program/
Can understanding antinutrients and the importance of a balanced diet help individuals get the most out of their foods?
Antinutrients
Antinutrients are compounds in some plant foods that can reduce the body’s ability to absorb and use certain nutrients. (Petroski W., & Minich D. M. 2020) The purpose of these compounds is to protect the plants from infections and insects, which benefits the plant. It can also lower the human body’s ability to absorb nutrients properly. They are found in many grains, legumes, seeds, nuts, fruits, and vegetables. Plant-based foods high in antinutrients have beneficial nutrients, such as antioxidants, fiber, and other vitamins and minerals, and have been associated with a lower risk of chronic disease. The antinutrients may prevent the digestion and absorption of some minerals and have other negative effects that include:
Altered gut function
Increased inflammation
Endocrine disruption
Increased risk of calcium kidney stones
Common Types
Some of the main antinutrients of concern include phytates, lectins, oxalates, tannins, and phytoestrogens.
Phytates (phytic acid)
They are found in grains, legumes, nuts, and seeds.
They are found in various plant foods, including fruits, vegetables, nuts, and grains. (Mitchell T. et al., 2019)
Oxalates bind to certain minerals, such as calcium-forming calcium oxalate.
Tannins
They are found in many plant foods, such as legumes, cereal grains, nuts, cacao, leafy and green vegetables, coffee, and tea. (Ojo M. A. 2022)
Tannins are antioxidant-phenolic compounds that can reduce the absorption of some minerals and proteins in the body.
Phytoestrogens
They are found in various plant foods, such as fruits, vegetables, legumes, nuts, and seeds.
These estrogen-like compounds have many health benefits but may also act as endocrine disruptors (interfering with hormones). (Petroski W., & Minich D. M. 2020)
Effects on the Body
Antinutrient compounds typically bind to minerals or other nutrients, which inhibits digestion and absorption. For example,
How these foods containing antinutrient compounds are prepared and consumed can influence their impact on the body and the quantity consumed.
Advantages and Disadvantages
Plant foods have long been associated with improved health and a decreased risk of some chronic diseases, such as heart disease, diabetes, cancer, stroke, and others. (Craig W. J. et al., 2021) For most, the effects of antinutrients are not of major concern after processing and cooking. The benefits and drawbacks of consuming foods high in antinutrients include: (Petroski W., & Minich D. M. 2020)
Benefits
Some antinutrients act as antioxidants.
Some have cancer-fighting abilities.
Some may increase immune system function.
They are often sources of dietary fiber and other beneficial nutrients.
Drawbacks
It may be difficult for some individuals to digest.
Phytoestrogens may behave like endocrine disruptors.
High amounts of oxalates can contribute to kidney stones.
Cooking methods to minimize antinutrient content, like boiling, steaming
Autoclaving – a cooking process that uses high pressure and heat to cook and sterilize food.
Peeling the skins of fruits and nuts is effective for reducing tannins.
Combining foods to enhance nutrient absorption.
For example, pairing high-oxalate foods with high-calcium foods.
Combining different cooking and processing methods can completely degrade and reduce many antinutrient compounds. The exception is phytoestrogens, where boiling, steaming, and fermentation can increase antinutrients. (Petroski W. & Minich D. M., 2020)
Injury Medical Chiropractic & Functional Medicine Clinic
Individuals concerned about antinutrients in their diet and who want individualized advice on how to get the most out of the food they eat should consider consulting with a registered dietitian nutritionist or another healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.
Smart Choices, Better Health
References
Petroski, W., & Minich, D. M. (2020). Is There Such a Thing as “Anti-Nutrients”? A Narrative Review of Perceived Problematic Plant Compounds. Nutrients, 12(10), 2929. https://doi.org/10.3390/nu12102929
Gupta, R. K., Gangoliya, S. S., & Singh, N. K. (2015). Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. Journal of food science and technology, 52(2), 676–684. https://doi.org/10.1007/s13197-013-0978-y
Adamcová, A., Laursen, K. H., & Ballin, N. Z. (2021). Lectin Activity in Commonly Consumed Plant-Based Foods: Calling for Method Harmonization and Risk Assessment. Foods (Basel, Switzerland), 10(11), 2796. https://doi.org/10.3390/foods10112796
Mitchell, T., Kumar, P., Reddy, T., Wood, K. D., Knight, J., Assimos, D. G., & Holmes, R. P. (2019). Dietary oxalate and kidney stone formation. American journal of physiology. Renal physiology, 316(3), F409–F413. https://doi.org/10.1152/ajprenal.00373.2018
Ojo, M. A. (2022). Tannins in Foods: Nutritional Implications and Processing Effects of Hydrothermal Techniques on Underutilized Hard-to-Cook Legume Seeds-A Review. Preventive nutrition and food science, 27(1), 14–19. https://doi.org/10.3746/pnf.2022.27.1.14
Craig, W. J., Mangels, A. R., Fresán, U., Marsh, K., Miles, F. L., Saunders, A. V., Haddad, E. H., Heskey, C. E., Johnston, P., Larson-Meyer, E., & Orlich, M. (2021). The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients, 13(11), 4144. https://doi.org/10.3390/nu13114144
Harvard T.H. Chan School of Public Health. (2022). Are anti-nutrients harmful? https://nutritionsource.hsph.harvard.edu/anti-nutrients/
U.S. Department of Agriculture. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf
National Institutes of Health Office of Dietary Supplements. (2024). Iron. Retrieved from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
Unlock the potential of gua-sha and chiropractic care. Learn how it can enhance your well-being and relieve tension.
Introduction: Rethinking Musculoskeletal Pain Through a Functional Medicine Lens
As a nurse practitioner with two decades of experience in physical and functional medicine, I’ve seen firsthand how musculoskeletal pain disrupts lives—whether it’s the desk-bound professional with chronic neck tension, the athlete recovering from overuse injuries, or the aging adult with persistent back discomfort. While pharmaceutical interventions may offer temporary relief, the key to long-term healing often lies in a more integrative approach.
Gua Sha therapy, a time-tested East Asian technique, combined with chiropractic care, offers a powerful, evidence-informed, and non-surgical strategy to alleviate musculoskeletal pain, restore function, and improve mobility. In this article, we’ll explore how these two modalities complement each other, the science behind their synergistic benefits, and how they can be integrated into a personalized treatment plan to support whole-body healing.
What Is Gua Sha Therapy? A Functional Medicine Perspective
Gua Sha (pronounced “gwah-shah”) is a traditional healing modality rooted in Traditional Chinese Medicine (TCM), involving the use of a smooth-edged instrument—often made of jade, rose quartz, or stainless steel—to gently scrape the skin in targeted areas. The goal? To release stagnation, promote microcirculation, and activate the body’s innate healing response.
The term “Gua” means “to scrape” and “Sha” refers to the reddish marks that appear on the skin, signifying the release of stagnant blood and toxins. These marks typically fade within a few days and are a normal part of the healing process.
In the modern clinical setting, Gua Sha has evolved into a sophisticated tool used by physical therapists, chiropractors, acupuncturists, and functional medicine providers. It’s particularly effective in addressing myofascial tension, trigger points, chronic inflammation, and reduced mobility due to soft tissue adhesions.
How Gua Sha Alleviates Musculoskeletal Pain
Musculoskeletal pain is often multifactorial—stemming from overuse, injury, postural imbalances, or systemic inflammation. When these factors are left unaddressed, they can lead to myofascial restrictions, scar tissue formation, and neuromuscular dysfunction, perpetuating a cycle of pain and immobility.
Gua Sha works by:
Disrupting fascial adhesions and encouraging tissue remodeling
Enhancing microvascular circulation, accelerating the delivery of oxygen and nutrients to the affected tissues
Activating the parasympathetic nervous system, shifting the body from “fight or flight” to “rest and repair”
Reducing pro-inflammatory cytokines and promoting anti-inflammatory responses (Chu et al., 2021)
Stimulating lymphatic flow, helping to reduce edema and clear metabolic waste
Releasing trigger points in hypertonic muscle groups, particularly in the neck, shoulders, lower back, and limbs
These mechanisms align well with the goals of functional medicine: identifying and treating root causes rather than masking symptoms.
Chiropractic Care: Aligning Structure and Function
Chiropractic care focuses on restoring proper spinal alignment and joint mobility through manual manipulation techniques. It is based on the principle that optimal nervous system function depends on structural integrity, particularly of the vertebral column.
Common benefits of chiropractic care include:
Pain reduction in the back, neck, and extremities
Improved range of motion and posture
Decompression of nerve roots, reducing radiculopathy and referred pain
Enhanced proprioception and neuromuscular coordination
Prevention of degenerative joint changes through biomechanical correction
A growing body of research supports chiropractic adjustments as an effective, evidence-based option for managing musculoskeletal conditions, especially when integrated into a multimodal treatment approach (Trager et al., 2024).
Discovering the Benefits of Chiropractic Care- Video
Gua Sha and Chiropractic Care: A Synergistic Duo
When Gua Sha is combined with chiropractic care, the result is a comprehensive therapeutic approach that targets both soft tissue restrictions and structural misalignments. This synergy accelerates healing and maximizes outcomes by preparing the body for more effective manual adjustments.
Here’s how the two modalities work together:
Gua Sha Therapy
Chiropractic Care
Breaks down adhesions in fascia and muscle tissue
Restores joint alignment and spinal biomechanics
Stimulates lymphatic and circulatory systems
Reduces nerve impingement and improves neural signaling
Releases tension in overactive muscle groups
Restores balance and mobility in underactive joints
Supports parasympathetic activation
Reinforces proprioceptive and neuromuscular patterns
One specific chiropractic application of Gua Sha is the Graston Technique, a modern adaptation that uses stainless steel instruments to identify and treat areas of soft tissue fibrosis. The goal is similar—restore mobility, reduce pain, and promote tissue healing (Deshmukh & Phansopkar, 2023).
Clinical Applications: When to Consider Gua Sha + Chiropractic Integration
As a nurse practitioner in functional medicine, I often incorporate both Gua Sha and chiropractic care for patients with:
These patients often report improved mobility, reduced inflammation, and greater pain relief when Gua Sha is included in their care plan—especially when timed before or after a chiropractic adjustment to reduce soft tissue guarding and enhance adjustment efficacy.
The Science: What Does the Research Say?
Numerous studies support the physiological effects of Gua Sha on circulation, inflammation, and pain modulation:
A 2021 study by Chu et al. found that Gua Sha therapy significantly increased microcirculation and decreased inflammatory markers in patients with chronic muscle pain.
Wang et al. (2020) highlighted Gua Sha’s role in stimulating the du meridian (governing vessel) and clearing blood stasis, promoting faster soft tissue recovery.
Knezevic et al. (2021) emphasized that musculoskeletal pain often arises from the interplay between soft tissue dysfunction, trigger points, and neural sensitization—areas where Gua Sha can provide targeted relief.
Trager et al. (2024) affirmed that chiropractic care continues to show promise as a cost-effective, non-pharmacological solution to chronic spinal pain and joint dysfunction.
Together, these therapies create a healing environment that supports the body’s biomechanical, neurological, and energetic systems.
Safety Considerations and Contraindications
While Gua Sha is a safe and gentle therapy, it is not suitable for everyone. Contraindications include:
Bleeding disorders or anticoagulant use
Severe varicose veins or vascular fragility
Active skin infections, open wounds, or dermatologic conditions
Recent surgeries with unhealed incisions
Always consult with a licensed provider trained in both modalities to determine appropriateness and ensure personalized, safe care.
Optimizing Results: A Functional Medicine Approach to Musculoskeletal Recovery
Incorporating Gua Sha and chiropractic care into a broader functional medicine care plan often yields the most sustainable results. Complementary strategies may include:
The body is a system of systems. Addressing musculoskeletal dysfunction holistically allows patients to heal not just their symptoms but the root cause of imbalance.
Conclusion: Empowering Patients With Integrative Pain Solutions
Musculoskeletal pain is one of the most common complaints in modern healthcare, yet the solution doesn’t have to be invasive, pharmaceutical, or surgical. By combining the ancient wisdom of Gua Sha with the mechanical precision of chiropractic care, we unlock a deeply therapeutic pathway toward healing, function, and resilience.
As a nurse practitioner grounded in both physical and functional medicine, I encourage patients and providers alike to explore the synergistic power of these modalities. When integrated skillfully and applied with intention, Gua Sha and chiropractic care can dramatically improve musculoskeletal health, restore balance, and empower patients to reclaim their active lives.
Injury Medical & Functional Medicine Clinic
We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal pain by incorporating Gua-Sha and chiropractic care. When asking important questions to our associated medical providers, we advise patients to utilize Gua-Sha combined with chiropractic care to reduce musculoskeletal pain and restore soft tissue mobility in the extremities. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Chu, E. C., Lin, A. F. C., & Chu, V. (2023). The Inclusion of Chiropractic Care in the Healthy China Initiative 2030. Cureus, 15(8), e43068. https://doi.org/10.7759/cureus.43068
Chu, E. C. P., Wong, A. Y. L., Sim, P., & Kruger, F. (2021). Exploring scraping therapy: Contemporary views on ancient healing – A review. J Family Med Prim Care, 10(8), 2757-2762. https://doi.org/10.4103/jfmpc.jfmpc_360_21
Deshmukh, N. S., Jr., & Phansopkar, P. (2023). Effect of the Graston Technique and Cupping Therapy on Pain and Functions in Individuals With Medial Tibial Stress Syndrome: A Randomized Clinical Trial. Cureus, 15(11), e48246. https://doi.org/10.7759/cureus.48246
Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. The Lancet, 398(10294), 78-92. https://doi.org/10.1016/s0140-6736(21)00733-9
Trager, R. J., Bejarano, G., Perfecto, R. T., Blackwood, E. R., & Goertz, C. M. (2024). Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med, 13(19). https://doi.org/10.3390/jcm13195668
Wang, Y. W., Xi, Z. W., Pu, B., Chen, G. Y., Ma, Y. F., Liu, D. L., & Xu, X. (2020). Gua sha therapy for chronic low back pain: A protocol for systematic review. Medicine (Baltimore), 99(40), e20606. https://doi.org/10.1097/MD.0000000000020606
For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?
Back Pain When Walking
Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.
Muscle Issues
Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)
Strains
Occur when the fibers in the back are overstretched or torn.
Pain from muscle strains is usually worse during activity and better when resting.
Sprains
It occurs when the ligaments that connect bone to bone become detached.
If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.
Fatigue
It can happen from overexertion and lead to lower back pain when walking.
It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.
Degenerative Disc Disease
Between each vertebra is a disc that provides cushioning between the bones.
As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)
Sciatica
Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)
Numbness
Tingling
Muscle cramps
Leg muscle weakness
Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.
Lumbar Spinal Stenosis
Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
It causes the space surrounding the spinal cord to narrow.
Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.
Hyperlordosis
Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)
Prevention Strategies
Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)
Wear shoes made for walking.
Perform gentle lower back stretches before walking.
Start slowly by walking for a few minutes, then gradually increase the time.
Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
Warm up and cool down by walking slowly at the beginning and end of the walk.
This allows the back and leg muscles to warm up before exercise and recover afterward.
Walk at a slow to moderate pace/speed that allows one to converse.
Standing up straight while walking or standing upright reduces pressure on the lower back.
Alternative Exercise
If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)
Elliptical Trainer
This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.
Recumbent Biking
will keep the back upright, which is recommended if there is more pain when bending forward.
Upright Stationary Biking
This is recommended if the back pain improves when bending forward.
Walking In A Pool
This activity provides benefits while reducing pressure on the spine.
To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).
Water Aerobics
This activity provides cardiovascular health benefits with decreased pressure on the back.
Injury Medical Chiropractic & Functional Medicine Clinic
See a physical therapist for a personalized exercise program to reduce back pain and appropriate for your condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
American Association of Neurological Surgeons. (2024). Low back strain and sprain. https://www.aans.org/patients/conditions-treatments/low-back-strain-and-sprain/
Hospital for Special Surgery. (2024). Degenerative disc disease. https://www.hss.edu/condition-list_degenerative-disc-disease.asp
American Academy of Orthopaedic Surgeons. (2021). Sciatica. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica
American Academy of Orthpaedic Surgeons. (2021). Lumbar spinal stenosis. https://orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/
American Academy of Orthopaedic Surgeons. (2020). Spine basics. https://orthoinfo.aaos.org/en/diseases–conditions/spine-basics/
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
Harvard Health Publishing. (2015). 5 tips for getting started with a walking program. https://www.health.harvard.edu/exercise-and-fitness/get-started
Hospital for Special Surgery. (2023). Best types of exercise for back pain. https://www.hss.edu/article_best-exercise-lower-back-pain.asp
What are some leg-strengthening exercises that will expedite recovery for athletes and physically active individuals who have undergone leg surgery?
Post Surgery Leg Strengthening
Leg muscles may weaken after hip, knee, ankle, or foot surgery. This happens because those muscles are not used as much during recovery. Gaining back strength and muscle endurance after an injury or surgery is an important step in recovery. Leg exercises can help regain mobility and prevent complications like blood clots and pressure sores after surgery or an injury, which is why engaging in post-surgery leg strengthening is important once the doctor gives the ok.
Benefits
post-surgery leg strengthening exercises have several benefits, including
Rebuilds strength and confidence
Retraining for optimal mobility and flexibility
Prevents pressure sores
Prevents blood clots
When the leg muscles are contracted, they move blood like a pump, maintaining proper circulation. Moving in a bed after surgery also helps prevent pressure sores from forming and blood clots. A physical therapy team will determine the right leg exercises for each individual and their injury/condition. This is an important step when moving forward after surgery. (Hoogeboom T. J. et al., 2014)
This isometric exercise means the muscles contract while no motion occurs at the hip joints. To perform:
Lie on your back and tighten your buttock muscles.
Hold the muscles tight for 5 seconds, then relax.
Repeat 10 or 15 times.
Gluteal sets can be done several times per day.
Heel Slide
Heel slides can help regain strength in the major muscles of the leg. To perform:
Lie on your back.
Bend the knee of the surgical leg and slowly slide the heel toward your butt.
Slide as far as possible and hold for 5 seconds.
Slowly return to the starting position and repeat.
Short Arc Quad
The short arc quad, or SAQ, is a simple way to get the quadricep muscles working. To perform:
Lie on your back with a towel roll, small ball, or something similar under the knee.
Slowly straighten the knee.
Tighten the quad muscle on the top of the thigh.
Hold for 3 seconds, then relax.
Repeat 10 to 15 times.
Quad Set
This exercise helps get the quad muscles working. It also helps control the position of the kneecap. To perform:
Lie on your back.
Place a small towel roll under the knee.
Try to press the back of the knee flat against the floor.
Hold for 10 seconds and release.
Repeat 10 to 15 times.
Individuals can complete quad sets bilaterally or with both knees simultaneously. This makes the stronger leg help strengthen the weaker side.
Straight Leg Raise
To perform:
Lie on your back.
Lift your leg straight off the floor until it is at the height of the opposite bent knee.
Hold for 10 seconds and slowly lower.
Repeat 10 to 15 times.
Be sure to keep the knee straight for the entire exercise. Keep the opposite knee bent for comfort. To ensure the knee is straight, individuals can complete a quad set first and then the straight leg raise. The exercise can be more challenging by increasing repetitions or adding a 2- to 3-pound ankle weight on the thigh. For even more challenge, add the ankle weight to the ankle.
Hamstring Strengthening
Working out the hamstrings after injury or surgery is important. The hamstring muscles bend the knee and extend the hip backward. To perform:
Lie on your stomach.
Bend one knee to raise the lower limb straight in the air.
Hold for 5 seconds and lower slowly.
Repeat 10 to 15 times.
Once the exercise is easy to do, increase the repetitions to 30. Individuals can also try adding a 2- to 3-pound ankle weight.
Physical therapy can help individuals regain mobility after injury or surgery. A therapist may prescribe exercises as part of an at-home exercise program. Over time progress will go from simple exercises to more challenging ones to improve balance and mobility. (Madara K. C. et al., 2019)
Injury Medical Chiropractic & Functional Medicine Clinic
Before starting this or any other exercise program, consult a doctor and a physical therapist to find the right exercises for your situation. 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.
Are You Recovering From Ankle Sprains?
References
Hoogeboom, T. J., Dronkers, J. J., Hulzebos, E. H., & van Meeteren, N. L. (2014). Merits of exercise therapy before and after major surgery. Current opinion in anaesthesiology, 27(2), 161–166. https://doi.org/10.1097/ACO.0000000000000062
Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni, J., Jr., & Raisis, L. (2019). PROGRESSIVE REHABILITATION AFTER TOTAL HIP ARTHROPLASTY: A PILOT AND FEASIBILITY STUDY. International Journal of Sports Physical Therapy, 14(4), 564–581.
For individuals managing chronic pain conditions, can incorporating a personal TENS device help?
Personal TENS Device
Almost all physical therapy, chiropractic, acupuncture, and massage clinic healthcare providers offer TENS (transcutaneous electrical nerve stimulation) therapy. Individuals can buy a TENS unit for on-the-go and home care use. A personal TENS unit is a small, battery-powered device that uses low-voltage electrical currents delivered through electrodes placed on the skin to help relieve pain.
How It Works
TENS units work by stimulating nerve fibers in pain, which can help block pain signals from reaching the brain or by stimulating the release of endorphins, the body’s natural pain-killing chemicals.
Uses
TENS units are used to treat a variety of conditions, including:
Arthritis
Muscle cramps
Neck pain
Back pain
Pelvic pain
Knee pain
Osteoarthritis
Fibromyalgia
Tendinitis
Bursitis
Diabetes-related neuropathy
Pelvic pain from periods or endometriosis
Features
Portability
TENS units are small, lightweight, and portable, making them convenient for home or on the go. It can be held in a pocket or clipped to a belt. (National Health Service UK, 2025)
Electrodes
The unit is connected to a series of electrodes placed on the skin to deliver the electrical charge.
Adjustable Settings
Many TENS units allow users to adjust the electrical pulses’ intensity, frequency, and duration.
Benefits
Non-Invasive
TENS therapy is a non-invasive method for relieving pain.
Drug-Free
It can provide pain relief without the need for medication.
Convenient
TENS units are small, portable, and relatively discrete.
Precautions
Consult a healthcare provider before using a TENS device to ensure its safety for you and your injury/condition. The treatment should not be used for individuals who are pregnant, have epilepsy, poor sensation, a heart problem, a pacemaker, or another electrical or metal implant in their body. (National Health Service UK, 2025) The electrodes should not be placed on certain areas of the body, including (Teoli D, Dua A, An J. 2025)
Head
Eyes
Mouth
Front of the Neck
Chest and upper back at the same time
Numb areas
Broken skin
Tumors
There is a minor risk of skin irritation, particularly if allergic to the adhesive pads.
Effectiveness
Researchers are still determining how effective TENS units are for relieving and reducing pain. A study found that TENS was effective in relieving pain for patients with fibromyalgia. (Dailey D. L. et al., 2013) Another study suggested that TENS may improve bone pain for cancer patients, but the results were inconclusive because of the limited number of randomized trials. (Vance C. G. et al., 2014)
Research suggests that some factors can impact the effectiveness of the intervention. Varying the intensity and frequency may help it be more effective so the body doesn’t develop a tolerance to it. In addition, using the electrodes in areas that are acupuncture points may help to reduce pain. While further study is needed, TENS is considered a safe pain-relief option for many conditions because it’s non-invasive and doesn’t require medication. (Vance C. G. et al., 2014)
Injury Medical Chiropractic & Functional Medicine Clinic
Individuals interested in trying a personal TENS unit should consult their healthcare provider. They may be able to refer them to a physical therapist, who can show them which type and how to use it for their particular condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Don’t Ignore Post-Accident Pain
References
National Health Service UK. (2025). TENS (transcutaneous electrical nerve stimulation). https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/
Teoli, D., Dua, A., & An, J. (2025). Transcutaneous Electrical Nerve Stimulation. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30725873
Dailey, D. L., Rakel, B. A., Vance, C. G. T., Liebano, R. E., Amrit, A. S., Bush, H. M., Lee, K. S., Lee, J. E., & Sluka, K. A. (2013). Transcutaneous electrical nerve stimulation reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain, 154(11), 2554–2562. https://doi.org/10.1016/j.pain.2013.07.043
Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain management, 4(3), 197–209. https://doi.org/10.2217/pmt.14.13
