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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

Exploring the Importance of Planes of Motion

Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?

Planes of Motion

The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)

  • Sagittal plane -Divides the body into right and left sides.
  • Frontal plane – Divides the body into front and back.
  • Transverse plane – Divides the body into top and bottom sections.

To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.

Sagittal Plane

Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane.  Several eating mechanics occur in the sagittal plane. Movements include:

  • Flexion – A bending movement that decreases the angle at a joint
  • Extension – An extending movement that increases the angle at a joint
  • Hyperextension – Extending the angle at a joint beyond neutral
  • Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin
  • Plantarflexion – Pushing the foot down and away from the body

Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.

Frontal Plane

The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:

  • Abduction – Moving the body or a limb laterally and away from the body’s midline.
  • Adduction – Moving the body or a limb towards the body’s midline.
  • Elevation – Moving the shoulder blades up.
  • Depression – Moving the shoulder blades down.
  • Eversion – Rolling the foot towards the inside/medial side.
  • Inversion – Rolling the foot towards the outside/lateral side.

Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.

Transverse Plane

The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:

  • Rotation – Moving the torso or a limb around its vertical axis.
  • Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
  • Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
  • Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
  • Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.

Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.

Training Within the Planes of Motion Benefits

Training in all three planes can help with movement in several ways, providing greater ease in life and sports.

Prepares Body for Daily Tasks

Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.

In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.

Prepares Body for Sports and Physical Activities

Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.

Encourages Variation For Full Body Strengthening

Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.

Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance 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.


The Difference of Using Custom Foot Orthotics


References

National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. https://blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. https://doi.org/10.2165/11534950-000000000-00000

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

Understanding Heartburn: Waking Up to Discomfort

Individuals who wake up with a burning feeling in the chest or throat, along with a bitter taste, more than likely are experiencing morning or waking heartburn. Can simple steps, like not having any food three hours before going to bed, help prevent heartburn when waking up?

Waking Up With Heartburn

Heartburn is characterized by a burning sensation in the chest and neck and an acidic, bitter taste. It occurs when stomach acid flows into the esophagus tube that connects the throat to the stomach and often happens when lying down. Heartburn is a symptom of acid reflux, a digestive disorder that occurs when the stomach contents back up into the esophagus. Waking up with heartburn throughout the night or when waking in the morning is common during pregnancy and after drinking alcohol. (UCSF Health, 2024) But chronic acid reflux can also be a sign of a health condition like gastroesophageal reflux disease (GERD) and hiatal hernia, or another condition may cause it and can be triggered by stress, certain foods, and other factors.

Causes

Having occasional heartburn is normal. However, frequently waking up with heartburn may indicate gastroesophageal reflux disease (GERD). Other possible causes of this condition and factors that may contribute to frequently waking up with heartburn include: (National Library of Medicine, 2023)

  • Increased stress
  • Wearing belts or clothes that are tight around the waist.
  • Medications include sedatives, bronchodilators, beta-blockers, calcium channel blockers, and tricyclic antidepressants.
  • Pregnancy
  • Hiatal hernia – the top area of the stomach pushes through an opening in the diaphragm.

Sleeping and Heartburn

Research shows a relationship between sleep disorders like insomnia and an increased risk of acid reflux (Qin S. et al., 2023). A study of over 6,000 people found that those who woke up less often during the night were 50% less likely to experience heartburn than those with disrupted sleep.

Symptoms

Symptoms can include: (Johns Hopkins Medicine, 2024)

  • A burning sensation in the chest that can last from minutes to hours
  • Pain in the chest when lying down or bending
  • Burning sensation in the throat
  • A hot, acidic, and/or salty sour taste in the back of the throat

Along with these symptoms, individuals who have GERD may also experience: (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Chronic cough or hoarseness
  • Pain and difficulty swallowing
  • Nausea
  • Chest pain

When symptoms are constant, it’s important to see a healthcare provider.

See a Healthcare Provider

If heartburn persists long-term, it can lead to inflammation, breathing problems, and narrowing of the esophagus. Seeing a healthcare provider is recommended if lifestyle adjustments don’t help or symptoms continue despite taking over-the-counter antacids. Other symptoms that need professional diagnosis include: (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Chest pain or difficulty breathing, like wheezing or hoarseness
  • Loss of appetite, nausea, vomiting
  • Unexpected weight loss
  • Difficulty swallowing
  • Signs of blood in the digestive tract or stool

Tell a healthcare provider when and how you are experiencing symptoms. It may be helpful to keep a journal of frequency, specific symptoms, times when waking up with heartburn, what foods and the time of day when eating, and any other information.

Heart Attack Symptoms

Heartburn can feel like the chest pain associated with a heart attack. See a healthcare provider if you’re unsure if your heart or digestive system is causing the discomfort. Seek emergency medical attention if you have any of the following (American Heart Association, 2022)

  • Squeezing pressure, fullness, or pain in the center of the chest that lasts several minutes or stops and returns
  • Shortness of breath with or without chest pain
  • Pain in either or both arms, the back, neck, jaw, or abdomen
  • Other signs include lightheadedness, nausea, and breaking out in a cold sweat 

Diagnosis

A healthcare provider can diagnose heartburn and related conditions based on the following (UCSF Health, 2024)

  • Discussing symptoms
  • X-rays, or imaging tests, that look at the esophagus, stomach, and small intestine
  • An esophageal pH monitoring test that checks how often and how long stomach acid stays in the esophagus
  • An upper endoscopy procedure where a small tube with a camera is inserted down the mouth to examine the esophagus and stomach

Prevention

Making a few lifestyle changes can reduce waking up with heartburn (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Elevate body when sleeping
  • Stop eating at least three hours before going to bed
  • Lose weight
  • Avoid spicy, high-fat, and acidic foods
  • Limit coffee and other forms of caffeine
  • Avoid carbonated drinks and alcoholic beverages

Staying hydrated helps with overall digestion. However, drinking too much water at once can make heartburn worse. Drinking small amounts throughout the day and avoiding sparkling water is recommended since carbonated drinks can trigger heartburn. (Harvard Health Publishing, 2023)

Treatment

There are various over-the-counter and prescription medications for heartburn. (National Institute of Diabetes and Digestive and Kidney Disease, 2020) Be sure to discuss the risks and benefits of the medicines with your healthcare provider. Heartburn treatments include:

Antacids

  • These oral over-the-counter medications help relieve symptoms of mild heartburn and GERD.
  • They should not be used daily or for severe symptoms as they can cause side effects like diarrhea or constipation.

H2 Blockers

  • Histamine-2 receptor antagonists – These medications reduce the stomach’s acid to help promote healing in the esophagus.
  • H2 blockers are available over-the-counter and by prescription.

Proton Pump Inhibitors (PPIs)

  • These medications, available over-the-counter and by prescription, reduce acid and help heal the esophageal lining in individuals with GERD.
  • They are often used for long-term treatment.

If medication and lifestyle changes don’t help, a healthcare provider may recommend surgery to strengthen the valve between the esophagus and stomach. (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

Injury Medical Chiropractic and Functional Medicine Clinic

Lifestyle and dietary changes, as well as medications, may be used to treat the condition. See a healthcare provider if your heartburn is persistent or accompanied by other symptoms. 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.


Functional Medicine’s Influence Beyond Joints


References

UCSF Health.(2024). Heartburn. https://www.ucsfhealth.org/conditions/heartburn

National Library of Medicine. (2023). Heartburn. Retrieved from https://medlineplus.gov/ency/article/003114.htm

Qin, S., Wang, C., Wang, X., Wu, W., & Liu, C. (2023). Causal association of gastroesophageal reflux disease with obstructive sleep apnea and sleep-related phenotypes: a bidirectional two-sample Mendelian randomization study. Frontiers in neurology, 14, 1283286. https://doi.org/10.3389/fneur.2023.1283286

Johns Hopkins Medicine. (2024). Gastroesophageal Reflux Disease (GERD). https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastroesophageal-reflux-disease-gerd

National Institute of Diabetes and Digestive and Kidney Disease. (2020). Symptoms and causes of GER & GERD. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes

American Heart Association. (2022). American Heart Association. Heartburn or Heart Attack? https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/heartburn-or-heart-attack

Harvard Health Publishing. (2023). 9 at-home treatments for acid reflux. https://www.health.harvard.edu/newsletter_article/9-ways-to-relieve-acid-reflux-without-medication

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/