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The Importance of the Long Thoracic Nerve in Shoulder Function

Can understanding the anatomy and function of the long thoracic nerve help individuals make informed healthcare decisions after an injury to the nerve?

Long Thoracic Nerve

Also referred to as the posterior thoracic nerve, the long thoracic nerve/LTN is a thin superficial nerve that runs from the cervical spine to the chest wall side of the trunk. It supplies motor function to the thorax’s serratus anterior muscle, helping stabilize the shoulder blade. Injury to this nerve can cause limited or abnormal shoulder and shoulder blade motion, including difficulty raising the arm during overhead reaching.

Anatomy

The long thoracic nerve originates from the ventral rami of cervical nerves C5, C6, and C7. (Waxenbaum JA, Reddy V, Bordoni B. 2023) In some individuals, the root from C7 is absent; in others, a small nerve root branches from C8. The nerve roots from C5 and C6 go through the medial scalene muscle to join the C7 nerve. It travels behind the brachial plexus axillary artery and vein and courses down the lateral side of the thorax. The long thoracic nerve terminates at the lower portion of the serratus anterior muscle, sending small nerve tendrils to each muscle’s projections, which attach to the ribs. Because the long thoracic nerve is located on the lateral side of the chest, it is vulnerable to injury during sports or surgical procedures. The nerve also has a smaller diameter than other cervical and brachial plexus nerves, which increases its potential for injury.

Function

The long thoracic nerve attaches to the underside of the shoulder blade and inserts as muscular slips into the ribs. It supplies motor function to the serratus anterior muscle, essential for normal shoulder motion. When it contracts, it pulls the shoulder blade against the ribs and thorax, helping to move and stabilize the arm as it moves forward and up during shoulder motions. Injury to the long thoracic nerve causes a condition called scapular winging. This occurs when the serratus anterior muscle becomes weakened or paralyzed after injury. (Lung K, St Lucia K, Lui F. 2024)

Susceptibility to Injury

The LTN is relatively unprotected and can be damaged by several things, including:

  • Heavy backpacks
  • Sports
  • Activities the body is not used to, like digging
  • Using crutches

Conditions

Injury to the long thoracic nerve may occur as a result of trauma, lifting heavy weights above the shoulder, or a surgical procedure. Surgical procedures that may place the nerve at risk for injury may include: (Lung K, St Lucia K, Lui F. 2024)

  • Axillary lymph node dissection
  • Improperly placed intercostal drains
  • Chest tube placements
  • Mastectomy
  • Thoracotomy

The long thoracic nerve is protected during these procedures by the surgeon and proper surgical technique, but occasionally, difficulties arise during surgery, and the nerve may become injured. Individuals may also have an anatomical variance that places their nerves in varying positions. The surgeon may not see it and accidentally injure their nerves during surgery.

The superficial long thoracic nerve may also be injured during sports or trauma to the trunk. A blow to the side or a sudden overhead stretch to the shoulder may be enough to damage the nerve, paralyzing the serratus anterior muscle.

Weakness or paralysis of the serratus anterior muscle will result in a winged scapula. To test for this:

  • Stand about two feet from a wall, facing it.
  • Place both hands on the wall and gently push against it.
  • If one of the shoulder blades sticks out abnormally, it could be a winged scapula.
  • Have a family member or friend stand behind you and check the shoulder blade position.
  • If you suspect a winged scapula, visit a physician who can assess the condition and determine if there is a long thoracic nerve injury.

Winging the scapula may result in difficulty lifting the arm overhead. The serratus anterior muscle works with other scapular stabilizers, such as the upper trapezius and levator scapula, to properly position the shoulder blade when lifting the arm. Failure of the serratus to stabilize the shoulder blade may make lifting the arm impossible.

Clinical examination is usually used to diagnose a long thoracic nerve injury. X-rays and MRIs cannot show the nerve injury directly, although an MRI can show some secondary signs to help confirm the diagnosis. An electromyographic or EMG test may also be performed to examine the function of the long thoracic nerve.

Treatment and Rehabilitation

Treatment for LTN pain and reduced movement may include:

  • Rest
  • Heat or ice
  • Anti-inflammatory pain medication
  • Neck support or a pillow
  • Avoiding strenuous activity and driving

If the long thoracic nerve is severely injured and the serratus anterior is completely paralyzed, the best course of action is to be active and monitor the condition. Full recovery of arm function can take one to two years. If permanent nerve injury has occurred, surgery may be an option to restore shoulder motion and function. Several different kinds of surgery can be used to address winged scapula. (Vetter M. et al., 2017)

  • One involves transferring the pectoralis major tendon to the scapula (Vetter M. et al., 2017) so it functions as the serratus.
  • Often, the tendon has to be lengthened, which may be done using part of the hamstring tendon.
  • After surgery, individuals will likely wear a sling on their arm for a few weeks, and then gentle range-of-motion exercises will be initiated.
  • After eight to ten weeks, gentle progressive strengthening of the new tendon can begin.
  • Full shoulder motion and strength recovery are expected six to 12 months after surgery.

Physical therapy may be used to help improve serratus anterior functions. (Berthold J. B., Burg T. M., & Nussbaum R. P. 2017) Exercises to strengthen serratus function may include:

Supine Punches

  • Lie on your back and raise both arms toward the ceiling.
  • Make a fist and punch up toward the ceiling.
  • Ensure the motion is steady and deliberate, and keep the elbow straight.
  • Hold the position for three seconds, then slowly lower the arm to the starting position.
  • Perform 10 to 15 repetitions.
  • Holding a small dumbbell in your hands can make the exercise more challenging.

Pushup

  • Lie on your stomach and place your hands flat on the ground by your shoulders as if you were going to perform a pushup.
  • Perform a pushup and press further, allowing the shoulder blades to wrap around the thorax.
  • Hold this position for three seconds, and slowly release.
  • Perform 10 to 15 reps.
  • If this is too difficult, perform the pushup against a wall to reduce the effect of gravity on the exercise.

Scapular Winging in Depth


References

Waxenbaum, J. A., Reddy, V., & Bordoni, B. (2024). Anatomy, Head and Neck: Cervical Nerves. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844163

Lung, K., St Lucia, K., & Lui, F. (2024). Anatomy, Thorax, Serratus Anterior Muscles. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30285352

Vetter, M., Charran, O., Yilmaz, E., Edwards, B., Muhleman, M. A., Oskouian, R. J., Tubbs, R. S., & Loukas, M. (2017). Winged Scapula: A Comprehensive Review of Surgical Treatment. Cureus, 9(12), e1923. https://doi.org/10.7759/cureus.1923

Berthold, J. B., Burg, T. M., & Nussbaum, R. P. (2017). Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging. The Journal of the American Osteopathic Association, 117(2), 133–137. https://doi.org/10.7556/jaoa.2017.025

The Dangers of Sleep Debt: Health Consequences

Individuals who don’t get enough sleep at night can feel it in many ways. Can sleep deprivation or other sleep disorders contribute to an accumulated sleep debt?

Sleep Debt

Sleep debt is the difference between the amount of sleep an individual needs and the amount they get. It can accumulate over time and can negatively impact physical and mental health.

What Is It?

Regardless of the cause, sleep debt, also called a sleep deficit, is the accumulated amount of sleep loss from insufficient sleep. (Harvard Health Publishing, 2019) For example, if the body needs eight hours of sleep a night but only gets six, it has accumulated two hours of sleep debt for that particular night. This can occur due to sleep restriction, in which too few hours are spent sleeping, which can have significant consequences, especially if the debt builds.

The Effects

Sleep deprivation is linked to various mental and physical health problems, including:

  • Poor concentration or short-term memory
  • Depression and anxiety
  • High blood pressure
  • Heart disease
  • Diabetes
  • Kidney disease

Sleep deprivation can also contribute to other long-term health consequences. Individuals can have hallucinations and even a potentially increased risk of death. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006) Symptoms of discomfort and pain are also worsened by poor sleep.

Other Causes

Other possible causes of poor sleep quality can include individuals who have a sleep disorder such as insomnia, sleep apnea, or circadian rhythm disorders, which could lead to symptoms that are similar to those that occur with a sleep debt. (Columbia University Department of Neurology, 2022) Even though enough sleep hours were obtained, it could be fragmented, resulting in daytime sleepiness and other health issues. Some signs of sleep debt include:

  • Feeling tired throughout the day.
  • Having trouble focusing and reacting.
  • Feeling frustrated, cranky, or worried in social situations.
  • Having difficulty judging others’ emotions.

Even after sufficient sleep hours, individuals who wake up feeling unrefreshed may need to see a sleep physician or specialist for sleep testing.

Getting Out of Sleep Debt

Fortunately, the short-term effects of sleep deprivation can be reversed with sufficient rest. To recover from sleep debt, individuals can try: (Harvard Health Publishing, 2019)

  • Getting into a normal bedtime routine.
  • Using afternoon naps in moderation.
  • Avoiding stimulants, especially in the afternoon or evening.
  • Going to bed earlier.
  • Catching up by sleeping in on the weekends.
  • Keeping a sleep diary.
  • Changing their mattress.
  • Talking with a doctor.

Although sleep deprivation affects everyone, older adults seem to rebound quicker than young adults. Individuals may initially require sleeping longer than average to compensate for the recent losses. That’s why meeting daily sleep needs and following better sleep guidelines to preserve health and well-being are important. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with insomnia or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to sleep well, avoid deprivation side effects, and restore health. Through healthy sleep practices and lifestyle accommodations, individuals can recover from sleep debt and regain the benefits of quality rest. A chiropractic therapy team can assess your condition and develop a customized treatment plan. 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.


Move Better, Live Better, Chiropractic Care


References

Harvard Health Publishing. (2019). Weekend catch-up sleep won’t fix the effects of sleep deprivation on your waistline. Harvard Health Blog. https://www.health.harvard.edu/blog/weekend-catch-up-sleep-wont-fix-the-effects-of-sleep-deprivation-on-your-waistline-2019092417861

Colten, H. R., Altevogt, B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research (Eds.). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press (US).

Columbia University Department of Neurology. (2024). Sleep Disorders. https://www.neurology.columbia.edu/patient-care/specialties/sleep-disorders?id=42069

Maximizing the Benefits of Napping: Optimal Duration and Effects

Could regular daytime naps help individuals slow the aging process from natural brain shrinkage?

Taking Naps

Research and experts suggest that a short nap between 10 to 40 minutes provides the most benefits, including:

  • Improved mood
  • Cognitive performance
  • Alertness

A study suggests that daytime napping might prevent the brain from shrinking with age. (Paz V., Dashti H. S., & Garfield V. 2023)

Optimal Nap Time

A small study of young adults found that naps lasting 10 to 60 minutes immediately improved mood and alertness. However, most research shows that naps under 30 minutes offer the most benefit because individuals are less likely to enter the deep sleep stage or experience sleep inertia – a period of impaired alertness right after waking.  A meta-analysis also suggested that short naps reduce fatigue, increase productivity, and enhance physical performance. (Dutheil F. et al., 2021) A 10-minute nap is the most effective at improving:

  • Sleep latency or sleep onset latency (SOL)
  • Fatigue
  • Vigor
  • Cognitive performance

Some sleep specialists recommend that patients not take naps longer than 40 minutes, as too much napping could be unhealthy. Studies have shown that excessive daytime sleepiness and napping for over 60 minutes might increase the risk of type 2 diabetes and heart problems. (Yamada T, Nobuhiro S, Takashi K. 2016)

Health

In the study published in Sleep Health, researchers used data from over 30,000 participants aged 40 to 69 from the U.K. Biobank. Researchers examined genetic variants associated with taking naps regularly. (Paz V., Dashti H. S., & Garfield V. 2023) The researchers found a link between regular daytime napping and larger brain volume. The difference in brain volume between individuals who nap regularly and those who don’t was equivalent to 2.6 to 6.5 years of aging. However, no association was found between napping and cognitive performance reaction time or visual memory. The brain naturally shrinks with age, but this process is accelerated in individuals with neurodegenerative diseases and cognitive decline.

How To Avoid Napping for Too Long

Taking naps is good for you. But there’s a difference between healthy daytime sleep and counterproductive excessive sleeping.

  • Sleep specialists recommend setting an alarm for a nap or asking a family member, friend, or coworker to wake you up.
  • Individuals can try placing their phones or alarm clocks far away so they have to move to turn them off.
  • Individuals are recommended to stand up immediately to wake the body through movement and light exposure to avoid feeling groggy after a nap.
  • One study suggests consuming caffeine before a nap may be an effective countermeasure for sleep inertia. (Hilditch C. J., Dorrian J., & Banks S. 2016)
  • Engaging in physical activities before and after naps can also help promote wakefulness.

Sometimes, people feel exhausted for various reasons, such as stress and nutrition, rather than a lack of sleep. In these cases, sleeping more than the body needs will only worsen sleep quality at night. When individuals are experiencing daytime fatigue, rather than lying back down or sitting in bed, sleep specialists suggest walking around. This allows the fatigue to pass, and the patient can sleep better at night.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic’s goals are to help individuals enhance movement with less pain due to a condition after injury or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop 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 heal itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Secrets of Optimal Wellness


References

Paz, V., Dashti, H. S., & Garfield, V. (2023). Is there an association between daytime napping, cognitive function, and brain volume? A Mendelian randomization study in the UK Biobank. Sleep health, 9(5), 786–793. https://doi.org/10.1016/j.sleh.2023.05.002

Dutheil, F., Danini, B., Bagheri, R., Fantini, M. L., Pereira, B., Moustafa, F., Trousselard, M., & Navel, V. (2021). Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(19), 10212. https://doi.org/10.3390/ijerph181910212

Yamada T, N. S., Takashi K. (2016). Daytime napping, daytime sleepiness and the risk of metabolic diseases: dose-response meta-analysis using restricted cubic spline model. J Am Coll Cardiol., 67(13), 1951. https://doi.org/https://doi.org/10.1016/S0735-1097(16)31952-0

Hilditch, C. J., Dorrian, J., & Banks, S. (2016). Time to wake up: reactive countermeasures to sleep inertia. Industrial health, 54(6), 528–541. https://doi.org/10.2486/indhealth.2015-0236

Beyond Shakes: Innovative Ways to Enjoy Protein Powder

Can protein powder be used in different ways to effectively support nutrition goals for individuals who aim to build muscle, maintain weight, or acquire more protein in their diet?

Different Ways To Use Protein Powder

Protein powder is a quick and easy way to get protein before or after a workout. Add a scoop to a shaker bottle, mix with water, and you’re ready. However, having the same shake daily can become boring. Finding different ways to use protein powder can be a welcome change in workout nutrition habits. It is versatile, making it a great addition to smoothies, baked goods, oatmeal, yogurt, and more.

Health Benefits

How to Use

Learning different ways to use protein powder can help create an exciting and diversified menu, from meals to snacks. Individuals can use conventional or organic powder. Here are a few ideas:

Oatmeal

  • Adding protein powder to overnight oats or stovetop oatmeal is a great way to increase protein content.
  • Protein powder mixes well with oats and milk.

Baked Goods

  • Protein powder goes well with many baked goods.
  • Another way to use protein powder is to add it to brownie, muffin, cupcake, or cookie recipes.

Yogurt

  • Combine with yogurt and fruit for a nutrient and calorie-dense breakfast or snack to fuel the body.
  • It’s also a great post-workout snack.

Coffee

  • Adding protein powder to coffee makes it easy to increase daily protein intake.
  • Stir with a spoon, like adding powdered cream, or blend or froth hot coffee with protein powder to make it like a cappuccino.

Pancakes

  • Adding to a batch of pancakes is a great way to use protein powder.

How much protein powder per day?

Consuming one to two scoops (between 25 to 50 grams) daily is generally safe, which is what most recipes call for. Following the recommended dosage on the product label is highly recommended. The Recommended Dietary Allowance of protein for a healthy adult, regardless of age, is 0.8 grams per kilogram of body weight per day. (Wu G. 2016)

How long after a workout should protein powder be taken?

Whether running or lifting weights, consuming protein within the anabolic window approximately 30 minutes to two hours after a workout enhances muscle recovery, repair, and growth. (Aragon A. A., & Schoenfeld, B. J. 2013) Daily protein intake is recommended for improved performance, muscle growth, and optimal recovery. (Cintineo H. P. et al., 2018) Muscle building is 25 percent higher when protein intake is evenly spaced throughout the day. (Mamerow M. M. et al., 2014

Protein Shake Side Effects

Consuming the recommended amount of one to two scoops daily is generally safe and doesn’t have side effects. However, exceeding recommended daily intake can cause unwanted side effects that include:

  • Bloating
  • Flatulence
  • Increased bowel movements
  • Acne
  • Nausea
  • Thirst
  • Fatigue
  • Headache
  • Lack or loss of appetite

Studies have found that excess whey protein supplementation is associated with increased aggression, acne, and disturbance of the gut microbiota. (Vasconcelos Q. D. J. S. et al., 2021)

For individuals who want to get more out of their pre- or post-workout supplements, choose high-quality organic protein powders that contain all essential amino acids and wholesome ingredients with no fillers or additives. Consult a healthcare provider if considering supplementing with protein powder or looking to increase protein intake along with a registered dietitian to help determine how much protein is needed based on personal needs, activity, and fitness levels and goals.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. 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.


Benefits of a Healthy Diet and Chiropractic Care


References

Cintineo, H. P., Arent, M. A., Antonio, J., & Arent, S. M. (2018). Effects of Protein Supplementation on Performance and Recovery in Resistance and Endurance Training. Frontiers in nutrition, 5, 83. https://doi.org/10.3389/fnut.2018.00083

Gorissen, S. H. M., Crombag, J. J. R., Senden, J. M. G., Waterval, W. A. H., Bierau, J., Verdijk, L. B., & van Loon, L. J. C. (2018). Protein content and amino acid composition of commercially available plant-based protein isolates. Amino acids, 50(12), 1685–1695. https://doi.org/10.1007/s00726-018-2640-5

Batsis, J. A., Petersen, C. L., Cook, S. B., Al-Nimr, R. I., Driesse, T., Pidgeon, D., & Fielding, R. (2021). Impact of whey protein supplementation in a weight-loss intervention in rural dwelling adults: A feasibility study. Clinical nutrition ESPEN, 45, 426–432. https://doi.org/10.1016/j.clnesp.2021.07.006

West, D. W. D., Abou Sawan, S., Mazzulla, M., Williamson, E., & Moore, D. R. (2017). Whey Protein Supplementation Enhances Whole Body Protein Metabolism and Performance Recovery after Resistance Exercise: A Double-Blind Crossover Study. Nutrients, 9(7), 735. https://doi.org/10.3390/nu9070735

Fekete, Á. A., Giromini, C., Chatzidiakou, Y., Givens, D. I., & Lovegrove, J. A. (2018). Whey protein lowers systolic blood pressure and Ca-caseinate reduces serum TAG after a high-fat meal in mildly hypertensive adults. Scientific reports, 8(1), 5026. https://doi.org/10.1038/s41598-018-23333-2

Ha, D. J., Kim, J., Kim, S., Go, G. W., & Whang, K. Y. (2021). Dietary Whey Protein Supplementation Increases Immunoglobulin G Production by Affecting Helper T Cell Populations after Antigen Exposure. Foods (Basel, Switzerland), 10(1), 194. https://doi.org/10.3390/foods10010194

Wu G. (2016). Dietary protein intake and human health. Food & function, 7(3), 1251–1265. https://doi.org/10.1039/c5fo01530h

Aragon, A. A., & Schoenfeld, B. J. (2013). Nutrient timing revisited: is there a post-exercise anabolic window?. Journal of the International Society of Sports Nutrition, 10(1), 5. https://doi.org/10.1186/1550-2783-10-5

Mamerow, M. M., Mettler, J. A., English, K. L., Casperson, S. L., Arentson-Lantz, E., Sheffield-Moore, M., Layman, D. K., & Paddon-Jones, D. (2014). Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. The Journal of nutrition, 144(6), 876–880. https://doi.org/10.3945/jn.113.185280

Vasconcelos, Q. D. J. S., Bachur, T. P. R., & Aragão, G. F. (2021). Whey protein supplementation and its potentially adverse effects on health: a systematic review. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme, 46(1), 27–33. https://doi.org/10.1139/apnm-2020-0370

Improve Your Health with Bed Pilates: Try These Adapted Exercises

Can Pilates exercise movements be performed in bed for individuals recovering from illness or injury?

Bed Pilates

Pilates exercises can be practiced in bed. Joseph Pilates’ exercises and equipment, such as his patented V-shape bed, were designed to help rehabilitate injured individuals who had to stay on or near a bed. After a healthy night’s sleep, Pilates exercises dynamically stimulate circulation and the nervous system. They can also be used to calm the mind and body before going to bed.

  • Those with health concerns should check with their healthcare provider before starting any exercise program to ensure safety.
  • Beginners are recommended to learn the Pilates principles and movement fundamentals.

Here are a few Pilates mat exercises adapted for individuals who need or prefer to exercise in bed. A firm mattress is recommended, as a soft mattress will mess up the correct form, making the exercise ineffective.

Spine Twist

This exercise helps improve the flexibility of the spine and core, making it easier to move around, and supports healthy posture. (Geremia J. M. et al., 2015) Pilates exercises like the spine twist have been found to reduce low back pain and disability. (Notarnicola A. et al., 2014) To perform:

  • Sit up in bed, torso straight, abs engaged, and inhale.
  • Exhale as you turn your head and shoulders to the right.
  • Keep your torso straight, and imagine growing taller through the turn.
  • Inhale as you return to the starting position.
  • Exhale and turn to the other side.
  • Repeat five times on each side.

Tendon Stretch

The tendon stretch helps by improving flexibility in the hamstrings and calves. (Chinnavan E., Gopaladhas S., & Kaikondan P. 2015) To perform:

  • Sit up straight, legs straight out.
  • Bring heels together and use a towel to pull your feet towards you while pushing your heels away.
  • Hold for three seconds.
  • Next, without the towel, point your toes away.
  • Hold for another three seconds.
  • Do ten reps.

Double-Leg Stretch

The double-leg stretch is an intermediate exercise that works the abdominals and the core. If this move feels difficult, start with one leg at a time. Another option is to keep the knees slightly bent instead of extending the legs fully. To perform:

  • Bring both knees to your chest and, with your hands, press down on the ankles to stretch the lower back.
  • Pull in the abdomen.
  • Exhale and extend the arms up and the leg or legs as far out in front as possible.
  • Hold the position for ten seconds and then release.
  • Do ten reps.

Pelvic Curl

The pelvic curl builds strength in the lower back and core. To perform:

  • Bend knees and place feet on the bed hip-distance apart.
  • Curl your pelvis, squeeze the glutes, and lift your body.
  • Hold for five seconds.
  • Slowly count five seconds while lowering back down, imprinting the spine into the mattress.
  • Do ten reps.

Hip-Opening Exercise

A hip-opening exercise, or frog, can be done while lying down or sitting in bed. Hip openers help keep the spine and hips flexible and in alignment. To perform:

  • Bring the soles of your feet together and as close to the torso as possible.
  • Let the knees open up as far as possible, and that feels comfortable.
  • While in the stretch, breathe in and out as deep as possible.
  • If sitting, place hands on ankles and use forearms to push down on the knees for added stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. 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.


Home Exercises for Pain Relief


References

Geremia, J. M., Iskiewicz, M. M., Marschner, R. A., Lehnen, T. E., & Lehnen, A. M. (2015). Effect of a physical training program using the Pilates method on flexibility in elderly subjects. Age (Dordrecht, Netherlands), 37(6), 119. https://doi.org/10.1007/s11357-015-9856-z

Notarnicola, A., Fischetti, F., Maccagnano, G., Comes, R., Tafuri, S., & Moretti, B. (2014). Daily pilates exercise or inactivity for patients with low back pain: a clinical prospective observational study. European journal of physical and rehabilitation medicine, 50(1), 59–66.

Chinnavan, E., Gopaladhas, S., & Kaikondan, P. (2015). Effectiveness of pilates training in improving hamstring flexibility of football players. Bangladesh Journal of Medical Science, 14(3), 265–269. https://doi.org/10.3329/bjms.v14i3.16322

The Importance of Sleep for Athletes: Maximizing Performance

Athletic individuals must train regularly, eat healthy, and rest properly to recover and perform their best. Is sleep different for athletes?

Athletes and Sleep

Physical activity is an important component of a healthy lifestyle. Regular exercise increases longevity and can also reduce the risk of anxiety and depression and improve sleep (Centers for Disease Control and Prevention, 2024). When one area is lacking for athletes, overall performance can suffer. Evidence shows that more or extended sleep can benefit athletes and their recovery and performance. (Bird, Stephen P. 2013) Recommendations for athletes range between seven and nine hours nightly, and elite athletes are encouraged to get at least nine hours of sleep nightly and to treat sleep as much as athletic training and diet.

Sleep is essential for overall health and well-being for both athletes and non-athletes. Everyone needs sleep to feel restored and function their best daily. (Richard J. Schwab, 2024) Other physical benefits include:

Cardiovascular Recovery

This allows the heart to rest and cells and tissue to be repaired. (MedlinePlus, 2017) This can help the body recover after physical exertion. As an individual progresses through the stages of sleep, the changes in heart rate and breathing throughout the night promote cardiovascular health (National Heart, Lung, and Blood Institute, 2011)

Illness Prevention 

The proper amount of sleep helps the body recover from illness. During sleep, the body produces cytokines/hormones that help the immune system fight off infections. These therapeutic effects are important for an athlete’s recovery and performance.

Lack of Sleep Affects Performance

Poor quality and quantity of sleep can lead to several negative effects. Sleep deprivation reduces the ability to react quickly and think clearly. A lack of sleep also increases irritability and risk for anxiety and depression. Sleep-deprived individuals are more likely to make poor decisions and take unnecessary risks. From a physical standpoint, a lack of sleep increases the risk for medical concerns, including type 2 diabetes, high blood pressure, kidney disease, and stroke. When athletes do not receive adequate sleep, it can:

Inhibit Ability

  • In a study of sleep-deprived male team athletes, average and total sprint times decreased. (Skein, M. et al., 2011)

Decrease Accuracy

  • In a study, male and female sleep-deprived tennis players had decreased serve accuracy by up to 53% compared to performance after normal sleep. (Reyner L. A. & Horne J. A. 2013)

Cause Quicker Exhaustion

  • A study of male runners and volleyball players found that both athletes exhausted faster after sleep deprivation. (Azboy O. & Kaygisiz Z. 2009)

Decrease Reaction Time

Difficulty Learning and Decision Making

  • A lack of sleep negatively impacts cognitive skills and functions.
  • Athletes can become distracted, and decisions like passing the ball or going for the smash can be difficult or made too late.

Increases Risk of Injury

  • Research on middle—and high-school athletes showed that chronic lack of sleep was associated with increased rates of injury. (Milewski M. D. et al., 2014)

Increases The Risk of Illness or Immunosuppression

Athletic Sleep Hygiene

Common components to sleep well include:

Avoid alcohol and Caffeine

  • Before bedtime, these can interrupt sleep or lead to more disturbed sleep.

Have a Wind-Down Routine

  • Activities such as reading, bathing, or meditating can help the body relax and get ready for sleep.

Reduce Stressors

  • Not only do mental stressors affect sleep quality, but they also impact performance overall.

Create an Optimal Sleep Environment

  • A sleeping space should be dark and cool with little to no noise.
  • The environment should be used only for sleep and sex.

No Electronics Before Bed

  • This includes TVs, cell phones, and computers.
  • The blue light that these devices emit can affect circadian rhythm.

Don’t Stay Awake In Bed

  • If you can’t fall asleep after 20 minutes of trying, get out of bed.
  • Do a quiet activity in another space until you feel sleepy.

Avoid Overtraining

  • Keep a consistent training schedule so as not to overexert yourself.

Quick Naps

  • Keep naps brief. Naps should be longer than an hour and not after 3 p.m.

Injury Medical Chiropractic and Functional Medicine Clinic

The right bed and mattress contribute to overall health and can improve one’s quality of life. Doctor Alexander Jimenez, DC, at Injury Medical Chiropractic and Functional Medicine Clinic, says a healthy mattress can improve sleep, reduce pain, increase energy levels, and elevate mood. 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, prevent injury, and 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.


Lumbar Spine Injuries In Athletes


References

Centers for Disease Control and Prevention. (2024). Benefits of Physical Activity. Retrieved from https://www.cdc.gov/physical-activity-basics/benefits/?CDC_AAref_Val=https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm

Bird, Stephen P. PhD. (2013). Sleep, Recovery, and Athletic Performance: A Brief Review and Recommendations. Strength and Conditioning Journal, 35(5), 43-47. https://doi.org/DOI: 10.1519/SSC.0b013e3182a62e2f

Schwab, R. J. (2024). Overview of Sleep. Merck Manual Consumer Version. https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/sleep-disorders/overview-of-sleep

National Library of Medicine. MedlinePlus. (2017). Healthy Sleep Also called: Sleep Hygeine. Retrieved from https://medlineplus.gov/healthysleep.html

National Heart, Lung, and Blood Institute. (2011). Your guide to healthy sleep. Retrieved from https://www.nhlbi.nih.gov/resources/your-guide-healthy-sleep

Skein, M., Duffield, R., Edge, J., Short, M. J., & Mündel, T. (2011). Intermittent-sprint performance and muscle glycogen after 30 h of sleep deprivation. Medicine and science in sports and exercise, 43(7), 1301–1311. https://doi.org/10.1249/MSS.0b013e31820abc5a

Reyner, L. A., & Horne, J. A. (2013). Sleep restriction and serving accuracy in performance tennis players, and effects of caffeine. Physiology & behavior, 120, 93–96. https://doi.org/10.1016/j.physbeh.2013.07.002

Azboy, O., & Kaygisiz, Z. (2009). Effects of sleep deprivation on cardiorespiratory functions of the runners and volleyball players during rest and exercise. Acta physiologica Hungarica, 96(1), 29–36. https://doi.org/10.1556/APhysiol.96.2009.1.3

Taheri, M., & Arabameri, E. (2012). The effect of sleep deprivation on choice reaction time and anaerobic power of college student athletes. Asian journal of sports medicine, 3(1), 15–20. https://doi.org/10.5812/asjsm.34719

Milewski, M. D., Skaggs, D. L., Bishop, G. A., Pace, J. L., Ibrahim, D. A., Wren, T. A., & Barzdukas, A. (2014). Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. Journal of pediatric orthopedics, 34(2), 129–133. https://doi.org/10.1097/BPO.0000000000000151

Prather, A. A., Janicki-Deverts, D., Hall, M. H., & Cohen, S. (2015). Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep, 38(9), 1353–1359. https://doi.org/10.5665/sleep.4968

Sleeping with Lower Back Pain and Sciatica: Finding Relief 

Sleeping with lower back pain and sciatica can be difficult and frustrating. What are ways to get more comfortable sleep?

Sleeping With Lower Back Pain and Sciatica

Various factors can affect sleeping with lower back pain and sciatica, including age, injury and medical history, the mattress (e.g., soft vs. firm mattress), and sleep positions. Unfortunately, there’s no one-cure-all solution for this problem, and depending on the underlying cause/s, they can worsen the pain and cause sleep problems. For example, if a herniated disc places added pressure on the nerves in the lower back, twisting the spine can worsen the lower back pain, and sleeping in a fetal position can exacerbate the nerve pain. (UCF Health, N.D.)

Lower-Back Pain

Low-back pain can be activity-related, intermittent, or constant. (American Association of Neurological Surgeons, 2024) For some, it only occurs occasionally, such as when performing specific movements. For others, it can be excruciating, chronic, and disabling. Low-back pain is unique for everybody and can differ depending on the cause. Some low-back pain symptom descriptions include (Förster M. et al., 2013)

  • Aching pain deep in the back
  • Shooting pain flare-ups
  • Pain caused by slight pressure
  • Burning
  • Tingling

Sciatica Not Present

For some, low-back pain may be confined to a specific area known as axial back pain. (Förster M. et al., 2013) The pain may be felt in a band along the lower back and does not radiate down the legs or anywhere else.

Sciatica Present

Low-back pain with sciatica pain that radiates from the lower back or hip down the leg is the most common symptom of lumbar radiculopathy (compression of spinal nerve roots). (North American Spine Society, 2020) Sciatica symptoms include: (American Academy of Orthopaedic Surgeons, 2021)

  • Shooting pain from the lower back down the leg
  • Feeling like a bad leg cramp
  • Leg weakness
  • Sensory changes radiating down the leg – numbness, burning, and or tingling

Sleep Tools

Consider changing the mattress to improve sleeping with lower back pain and sciatica. For the best spinal support, choose a medium to firm mattress. Pillows, wedges, and other tools can also help improve sleep. (UCF Health, N.D.) It is recommended that individuals who sleep on their backs place a small pillow under their knees to reduce pressure on their lower backs. For those who sleep on their side, placing a pillow between the knees can keep the spine in a neutral/straight position. To relieve lower back pain, consider sleeping in a reclined, angled position with the head and shoulders higher than the hips. This can be accomplished with an adjustable bed or a wedge to prop the body in a regular bed.

Back Sleeping

Easing back pain while sleeping involves maintaining the body in a neutral or straight position. Extending the muscles, tendons, and ligaments too far in any one direction while sleeping with lower back pain and sciatica can cause stiffness, muscle spasms, and pain. Sleeping on the back puts the spine in neutral alignment with the least stress on the neck and back. It evenly distributes body weight to avoid exerting pressure on the joints and prevent backaches. In addition, a supine position allows outstretched ligaments to shrink and recover to their normal positions. (Keck Medicine of USC, 2019)

Chiropractic Assessment

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team may be best for individuals with acute back, neck, and musculoskeletal pain and discomfort symptoms. A chiropractor can quickly assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. 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.


Sciatica, Causes, Symptoms and Tips


References

UCF Health. (N.D.). The best sleeping position for lower back pain (and the worst). https://ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/

American Association of Neurological Surgeons. (2024). Low back pain. https://www.aans.org/patients/conditions-treatments/low-back-pain/

Förster, M., Mahn, F., Gockel, U., Brosz, M., Freynhagen, R., Tölle, T. R., & Baron, R. (2013). Axial low back pain: one painful area–many perceptions and mechanisms. PloS one, 8(7), e68273. https://doi.org/10.1371/journal.pone.0068273

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: Diagnosis and treatment of low back pain. North American Spine Society. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

American Academy of Orthopaedic Surgeons. (2021). Sciatica. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica

Keck Medicine of USC. (2019). The best -and worst – sleep positions for back pain. Keck Medicine of USC Blog. https://www.keckmedicine.org/blog/the-best-and-worst-sleep-positions-for-back-pain/

Customize Your Meditation Practice to Fit Your Personality

Do different meditation techniques work according to an individual’s personality type?

Meditation Techniques According To Personality Type

Meditation techniques come in many forms. The traditional practice of sitting cross-legged with eyes closed and hands in prana mudra form is just one technique. From loving-kindness meditation to sound baths, the Breethe App, and walking meditations, each type offers its way of calming and focusing the mind, reducing stress, and enhancing well-being.

Meditation for All

Meditation is about observing individual thoughts without judgment and staying in the present. Learning not to focus on every negative or hurtful thought that passes builds emotional regularity and a healthier relationship with the mind. However, no one-size-fits-all technique exists, and meditation relies on individual personality. Some feel more at peace sitting alone, while others find music soothing. Still others find peace of mind in taking a walk. Discovering the answers will help determine which meditation technique works best for you and your mind.

Choosing a Technique

There is no exact science to finding the best meditation technique for each personality. How one meditates is a personal decision. But for those new to meditation and unsure where to start or which practice works best, here are a few meditation techniques for every personality type.

Introverted

Mindfulness Meditation

Introverts harness energy alone and spend energy in social situations. Based on this, mindfulness meditation can work in a quiet, calm, and familiar setting. This type of meditation involves paying attention to the present moment and focusing on the breath, body sensations, and sounds. It helps relieve stress, generates mental clarity, enhances self-awareness, and improves emotional regulation. To practice mindfulness meditation:

  • Sit comfortably in a quiet space and close your eyes.
  • Focus on your breath as you slowly inhale and exhale.
  • Observe your thoughts without judgment, and try to redirect your breathing as you let the thought pass.

Introverts often find satisfaction in the structured approach, which helps them gain insight into their thoughts and behaviors. Research has found that those who participate in mindfulness-based stress reduction/MBSR benefit from decreased stress levels. (Chiesa A. & Serretti A. 2009)

Extroverts

Group Meditation

Extroverts love being in the mix of the world and fuel themselves through social interactions. They still benefit from meditation to calm and ground them, but in a group or class setting. Group meditation practices with a group, usually in-person or a virtual class led by an instructor. This type of meditation strengthens the sense of community and can deepen an extrovert’s meditation experience through the group’s energy.

Creative and Artistic

Artful Meditation

Creative individuals often create things through painting, sculpting, cooking, sewing, or other trades and crafts. The creative process creates a therapeutic atmosphere for this personality type, and engaging in creative activities can help them focus their minds and forget outside stressors. Artful meditation, or meditative art, combines this creativity with mindfulness. It involves engaging in artistic activities while meditatively concentrating on the process. The practice increases relaxation, provides self-expression, and encourages mindfulness. Individuals do not have to be artists to benefit, as it’s accessible and enjoyable for all skill levels.

Music Personality

Sound Bath Meditation

Individuals drawn to music appreciate and enjoy the combination of sounds that create harmonies, rhythms, and vibrations. Consider sound baths, which can provide a deep and emotional experience. A sound bath is a meditative experience where participants are “bathed” in sound waves produced by instruments like gongs, singing bowls, and chimes. Research has found that sound vibrations help reduce stress, enhance mental clarity, and improve emotional well-being. (Bartel L. & Mosabbir A. 2021) Classes are often led by an instructor and involve lying or sitting down with closed eyes while sounds and vibrations cascade. The music guides the experience and keeps the listener focused on the journey. The immersive musical meditation experience can help individuals process emotions, reduce stress, and cultivate connections with themselves and others.

Type A Personalities

Breathwork Meditation

Type A personalities strive for order and are ready to accomplish any challenge, which often leads to perfectionism burnout. Breathwork meditation can help avoid these pitfalls. This meditation focuses on controlling and manipulating one’s breath to calm the body, mind, and emotions. It’s very structured and orderly, which appeals to type-A individuals. One technique is box breathing, which involves breathing in for six seconds, holding for six seconds, exhaling for six seconds, holding for six seconds, and repeating.

Type B Personalities

Walking Meditation

Type B personalities are relaxed, easy-going, patient, and adaptable. These individuals benefit from flexible, open-ended meditation techniques that allow exploration and creativity. Walking meditation around nature or the block offers this as it combines movement with mindfulness. It focuses on the sensations of walking, like the feel of the ground under the feet and the rhythm of the steps. This creates a deeper connection with one’s surroundings. It also takes the practice of meditation into the world, helping integrate mindfulness into daily activities.

Pessimistic

Loving-Kindness Meditation

Pessimists typically have a glass-is-half-empty mentality, often focusing on the negative versus the positive. This form of meditation involves cultivating feelings of compassion, kindness, and goodwill toward oneself and others. For pessimists who struggle with negative self-talk and skepticism, loving-kindness meditation offers a structured practice for cultivating positive emotions and empathy. It can help soften inner criticism, foster resilience, and promote a compassionate worldview. To practice, sit quietly, focus on feelings of love and compassion, and repeat phrases like May I be healthy, may I have mental happiness, and may others be safe, happy, and peaceful. With practice, these sentiments are allowed to grow.

Optimistic

Affirmation Meditation

Optimists tend to see the brighter side of situations, expect favorable outcomes, and maintain a can-do attitude. Affirmation meditation, which involves repeating positive statements aloud or silently, can help reinforce positive beliefs and cultivate optimism. These may be phrases like “I am confident, grounded, or grateful for today.” Consciously affirming, uplifting statements strengthen optimists’ positive mindsets, increase their self-esteem, and sustain their natural inclination to see possibilities and opportunities.

Easily Distracted

Guided Meditation

Guided meditation may benefit individuals who are easily distracted or find it difficult to sit still. This structured approach allows individuals to show up and follow instructions. A narrator guides the practitioner by focusing on relaxation, visualization, or themes like gratitude or compassion. Guided voice meditation provides a clear framework and can be easier to follow, making it accessible for individuals new to meditation or those who find it difficult to focus.

Injury Medical Chiropractic and Functional Medicine Clinic

Ultimately, the best type of meditation technique is the one that works for you. Individuals may find that having a few variations can keep things interesting in your day-to-day life. A healthcare provider can determine the most effective treatment strategies. 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, 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.


Transform Your Body


References

Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. Journal of alternative and complementary medicine (New York, N.Y.), 15(5), 593–600. https://doi.org/10.1089/acm.2008.0495

Bartel, L., & Mosabbir, A. (2021). Possible Mechanisms for the Effects of Sound Vibration on Human Health. Healthcare (Basel, Switzerland), 9(5), 597. https://doi.org/10.3390/healthcare9050597

Primary Insomnia Explained: Symptoms and Solutions

Could learning to apply healthy sleep hygiene habits help improve sleep and overall health for individuals with sleeping difficulties?

Primary Insomnia

Insomnia affects most adults at some point in their lives. Primary insomnia is a fairly common condition characterized by difficulty sleeping, and sometimes, it can resolve without treatment. A diagnosis of primary insomnia means that there is no need to worry that a medical or psychological issue is causing sleep problems. Secondary insomnia is the result of medication side effects or medical or psychological issues. However, individuals may need a diagnostic evaluation, including blood tests or an overnight sleep study, to determine an underlying cause for persistent insomnia. Managing lifestyle habits is usually effective for the relief of primary insomnia. If that doesn’t work, medical treatment may be recommended.

Symptoms

Primary insomnia means not getting enough sleep. Individuals with primary insomnia average six hours of sleep per night (Flynn-Evans E. E. et al., 2017). They often toss and turn or get out of bed frequently. Typically, primary insomnia makes it hard to fall asleep and/or stay asleep. Individuals can wake up easily by triggers like noises or even without triggers. Sleep deprivation can lead to several health problems when awake. Symptoms of insomnia fatigue include: (Salisbury-Afshar E. 2018)

  • Trouble waking up in the morning
  • Constant yawning
  • Feeling tired and sleepy throughout the day
  • Lack of energy for physical activity
  • Lack of motivation
  • Hunger
  • Difficulty concentrating
  • Irritability
  • Headaches
  • Hypersomnia or falling asleep during the day
  • Sensitivity to noise or lights when awake
  • Bouts of hyperactivity
  • Jumpiness
  • Being easily alarmed or frightened

Individuals can experience these symptoms for a few days in a row and resolve the day after a restful night of sleep or after a nap. There are times when fatigue can help with falling asleep, which helps to resolve insomnia.

Complications

Individuals can develop severe anxiety and distress about the fact that they are not getting enough sleep. This anxiety is usually more severe before going to bed or in the middle of the night, but the worry can continue during the day as well. Persistent insomnia and chronic lack of sleep can lead to depression and predispose the mind and body to health complications. (Sun, Q., & Tan, L. 2019) Insufficient sleep is associated with lowered immune system function, obesity, and heart disease. (Hung C. M. et al., 2018)

Causes

The conundrum of primary insomnia is that it does not have an identifiable cause, but certain risk factors predispose individuals to have primary insomnia. The condition persists throughout a person’s life, often worsening or improving for months or years. Primary insomnia can be more common among those who have family members with insomnia. Research has found that, while primary insomnia isn’t caused by psychiatric issues, tending to stress or a worry-prone personality might be predisposing factors. (Hung C. M. et al., 2018)

Circadian Rhythm

Research has found that primary insomnia is associated with circadian rhythm irregularities. Primary insomnia can result from individuals falling into deeper sleep phases earlier than those who don’t have the condition. (Flynn-Evans E. E. et al., 2017) However, it can be challenging to know whether early deep sleep is a cause or an effect of primary insomnia. This is because sleep deprivation can also lead to deep sleep’s abrupt or rapid onset.

Diagnosis

Getting enough sleep is a common concern throughout life. Diagnosing primary insomnia involves various steps. One of the main components of identifying insomnia is determining whether the individual needs more sleep than they are getting. For individuals who are unable to get the proper amount of sleep, the second aspect of primary insomnia diagnosis is focused on finding the reason for their lack of sleep. Diagnostic tests measure insomnia and its effects and include:

Sleep Study

  • A polysomnogram is an overnight sleep study measuring brain activity, muscle activity, and breathing.
  • The polysomnogram is expected to show decreased sleep and normal breathing patterns if it is primary insomnia. (Sun, Q., & Tan, L. 2019)

Pittsburgh Sleep Quality Index 

  • The PSQI is a questionnaire that includes a self-assessment of sleep.
  • It helps identify sleep patterns and issues like using the bathroom frequently at night.

Multiple Sleep Latency Test

  • An MSLT is a daytime nap study in which participants are monitored to determine how fast they fall asleep.
  • The test results are a reflection of your sleep deprivation.

These studies help assess whether an individual is not getting enough sleep and what type of sleep interruption is experienced. Other tests might include screening questionnaires or other assessments of emotional issues like depression and anxiety. Sometimes, individuals are aware of these problems but may dismiss symptoms of depression and anxiety, and they instead manifest as insomnia.

Ruling Out Underlying Causes

Medical causes of insomnia can include: (Guo H. M. et al., 2017)

  • Thyroid disease
  • Liver disease
  • Dementia
  • Restless leg syndrome
  • Breathing problems. 

Individuals might need to have tests to determine whether any of these underlying issues are contributing to their insomnia. Individual medical symptoms and physical examination would guide the diagnostic testing.

Sleep Hygiene Habits

Individuals can start making small lifestyle adjustments to help regulate their sleep. The key is to avoid things that prevent falling asleep when you want to. Healthy habits include:

  • Avoid caffeine in the afternoon or evening.
  • Avoid alcohol.
  • Avoid napping during the day.
  • Don’t turn on a phone, computer, or television screen in the bedroom before going to bed.
  • Staying away from bright lights for several hours before sleep.
  • Scheduling tasks so you feel caught up before going to sleep.
  • Getting enough to eat so you aren’t hungry before going to bed.
  • Not eating so much that you feel bloated before going to bed.
  • Doing some light exercise several hours before going to bed.

Medical Treatment

If lifestyle habits don’t help alleviate insomnia, talk to a healthcare provider about medical therapy. Some notice a benefit from treatment with non-prescription-based strategies like counseling, cognitive behavioral therapy for insomnia (CBT-I), or acupuncture. These approaches can have a longer-lasting effect without the risk of side effects. (Salisbury-Afshar E. 2018) A healthcare provider might recommend melatonin or may prescribe medication such as antidepressants, antihistamines, or benzodiazepines.

Injury Medical Chiropractic and Functional Medicine Clinic

Navigating insomnia can be challenging, but understanding the treatment process can significantly help the individual. A healthcare provider can determine the most effective treatment strategies. This can include physical therapy, rest, health coaching, and medication. Overcoming these limitations is possible. 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, 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.


Building a Stronger Body


References

Flynn-Evans, E. E., Shekleton, J. A., Miller, B., Epstein, L. J., Kirsch, D., Brogna, L. A., Burke, L. M., Bremer, E., Murray, J. M., Gehrman, P., Rajaratnam, S. M. W., & Lockley, S. W. (2017). Circadian Phase and Phase Angle Disorders in Primary Insomnia. Sleep, 40(12), 10.1093/sleep/zsx163. https://doi.org/10.1093/sleep/zsx163

Salisbury-Afshar E. (2018). Management of Insomnia Disorder in Adults. American Family Physician, 98(5), 319–322.

Sun, Q., & Tan, L. (2019). Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder. Psychiatry Research, 282, 112514. https://doi.org/10.1016/j.psychres.2019.112514

Hung, C. M., Li, Y. C., Chen, H. J., Lu, K., Liang, C. L., Liliang, P. C., Tsai, Y. D., & Wang, K. W. (2018). Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study. BMC psychiatry, 18(1), 38. https://doi.org/10.1186/s12888-018-1623-0

Guo, H. M., Liu, M., Xiang, Y. T., Zhao, J., Ungvari, G. S., Correll, C. U., Ng, C. H., Chiu, H. F., & Duan, Z. P. (2017). Insomnia in Adults With Chronic Hepatitis B, Liver Failure, and Cirrhosis: A Case-Control Study. Perspectives in psychiatric care, 53(1), 67–72. https://doi.org/10.1111/ppc.12138