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Exercise and Dementia: Key to Cognitive Health

To what extent can regular exercise contribute to the overall health of elderly individuals and reduce the likelihood of developing dementia?

Exercise and Dementia: Improving Brain Function

Dementia Prevention and Exercise

Dementia is a term that refers to various diseases that impede memory and cognition, and it is presently the seventh most common cause of death worldwide. (World Health Organization, 2025) Approximately 10 million new cases of dementia are diagnosed annually on a global scale. (Yoon J.H. et al., 2023) A study investigating the correlation between insulin and exercise in the brain discovered that consistent physical activity may enhance brain function and reduce the likelihood of developing dementia. Researchers have discovered that factors such as.

Exercise and stretching are necessary. Muscle rigidity impairs insulin’s ability to work in those who don’t exercise. The body enhances insulin sensitivity by contracting and releasing those muscles in response to movement. Dementia prevention efforts might benefit from identifying mechanisms that lower insulin resistance.

Physical Activity and Reduced Risk

After observing 21 older individuals with prediabetes for two weeks, the researchers discovered that physical activity assists the brain in regulating insulin, directly improving cognitive function. Under supervision, they completed twelve exercise sessions that ranged from moderate to high intensity. (Malin S. K. et al., 2025)

  • The findings show a notable rise in the number of extracellular vesicles produced from the brain that contain insulin-related proteins.
  • These micro-messengers ensure that neurons can communicate with one another and play an essential part in maintaining the brain.
  • AKT (also known as protein kinase B or PKB) comprises three specific protein kinases that are important for many body functions, such as keeping cells alive, helping them grow, managing metabolism, and controlling the cell cycle.
  • The protein is considered a significant factor in insulin signaling and has ramifications for neuronal cell growth and health.
  • Inadequate insulin response may contribute to dementia. Hence, it is noteworthy that exercise could mitigate this by potentially enhancing insulin signaling.

Although further investigation is necessary, these results underscore that physical activity may be an accessible, cost-effective method to promote long-term cognitive health. In the subsequent phase of the investigation, researchers will employ an insulin spray and MRIs to gain further insight into insulin’s impact on brain activity. They will analyze cerebral blood circulation before and during the administration of the insulin spray to elucidate its effects.

Insulin, Exercise, and Brain Health

Insulin is a hormone synthesized by the pancreas that regulates blood glucose levels. Nonetheless, insulin’s significance in cerebral health is equally crucial. The brain’s abundance of insulin receptors facilitates neuronal communication, enhances synaptic connections upon insulin binding, and promotes memory and learning. (Gray, S. M., Meijer, R. I., & Barrett, E. J. 2014)

Impaired insulin signaling, as observed in situations such as type 2 diabetes, renders the brain more susceptible to cognitive deterioration. (Yoon J.H. et al., 2023) Research indicates that insulin resistance plays a role in the accumulation of amyloid-beta plaques and tau tangles, which are fundamental features of Alzheimer’s disease. (Hong, S., Han, K., & Park, C. Y. 2021) Enhancing insulin sensitivity may mitigate or avert these cerebral alterations. Aerobic exercise positively influences total brain health. Prior research has demonstrated that physical activity improves or sustains adult cognitive function and memory. (Rosenberg A. et al., 2020) Other ways to increase brain health include

  • Staying socially engaged
  • Challenging the mind
  • Getting plenty of sleep
  • Managing Stress
  • Healthy diet
  • Staying physically active
  • Diabetes management
  • Blood pressure management

The future of dementia prevention will likely entail a synthesis of lifestyle modifications, including physical activity and pharmacological treatments, to achieve the most significant impact. Consistent physical activity may substantially diminish the likelihood of dementia in adults with prediabetes or diabetes and support normal cognitive function.

Clinic for Chiropractic Care and Functional Medicine

Family Practice Nurse Practitioner Dr. Jimenez integrates sophisticated medical proficiency with chiropractic treatment to manage diverse illnesses. Our clinic combines Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to develop tailored care plans that enhance natural healing, mobility, and sustained wellness. By emphasizing flexibility, agility, and strength, we enable patients to flourish, irrespective of age or health obstacles. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we dedicate ourselves to treating individuals recovering from injuries and chronic pain disorders. We enhance your capabilities through flexibility, mobility, and agility programs customized for various age demographics and disabilities. We employ in-person and virtual health coaching and comprehensive care plans to guarantee tailored care and optimal wellness outcomes for each patient.


Is Motion Key to Healing?


References

World Health Organization. (2025). “Dementia.” World Health Organization. from https://www.who.int/news-room/fact sheets/detail/dementia#:~:text=Alzheimer%20disease%20is%20the%20most,60%E2%80%9370%25%20of%20cases.

Yoon, J. H., Hwang, J., Son, S. U., Choi, J., You, S. W., Park, H., Cha, S. Y., & Maeng, S. (2023). How Can Insulin Resistance Cause Alzheimer’s Disease?. International Journal of Molecular Sciences, 24(4), 3506. https://doi.org/10.3390/ijms24043506

Malin, S. K., Battillo, D. J., Beeri, M. S., Mustapic, M., Delgado-Peraza, F., & Kapogiannis, D. (2025). Two weeks of exercise alters neuronal extracellular vesicle insulin signaling proteins and pro-BDNF in older adults with prediabetes. Aging cell, 24(1), e14369. https://doi.org/10.1111/acel.14369

Gray, S. M., Meijer, R. I., & Barrett, E. J. (2014). Insulin regulates brain function, but how does it get there?. Diabetes, 63(12), 3992–3997. https://doi.org/10.2337/db14-0340

Hong, S., Han, K., & Park, C. Y. (2021). The insulin resistance by triglyceride glucose index and risk for dementia: population-based study. Alzheimer’s research & therapy, 13(1), 9. https://doi.org/10.1186/s13195-020-00758-4

Rosenberg, A., Mangialasche, F., Ngandu, T., Solomon, A., & Kivipelto, M. (2020). Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer’s Disease, and Dementia: From FINGER to World-Wide FINGERS. The Journal of Prevention of Alzheimer’s disease, 7(1), 29–36. https://doi.org/10.14283/jpad.2019.41

Sauerkraut and Its Incredible Health Benefits

Can incorporating sauerkraut into one’s diet help promote healthy gut bacteria?

Sauerkraut

Sauerkraut, a fermented cabbage food, is a great source of probiotics and fiber, both of which can contribute to gut health. It’s a living food containing various microbial strains and can help improve digestion, reduce inflammation, and improve overall gut health. (Shahbazi R. et al., 2021)

Fermented foods like sauerkraut have live cultures that promote the growth of beneficial probiotics, bacteria that provide powerful health benefits. Probiotics also help make foods more digestible, increasing the gut’s ability to absorb the vitamins and minerals they contain. A study found that fermented cabbage may help protect intestinal cells from inflammatory damage more than raw cabbage. (Wei L., & Marco M. L., 2025)

Homemade sauerkraut likely contains more live cultures than store-bought since processing may destroy some of the healthy bacteria. (National Institutes of Health Office of Dietary Supplements, 2023) Depending on which supplement is chosen, sauerkraut may have a greater diversity of probiotic strains. This is because an oral supplement has a known quantity and strain of probiotics. Individuals who want to add probiotics to their diet for potential gut health benefits should take a food-first approach, which is generally recommended over oral supplements. (National Institutes of Health, 2025)

Look at the Benefits

Probiotics

  • Sauerkraut contains lactic acid bacteria, which are beneficial bacteria that can help support the immune system and reduce inflammation. (Healthline, 2023)

Fiber

  • Sauerkraut is a robust source of fiber, which aids in digestion and can help you feel full longer.

Digestion

Anti-inflammatory

Gut Microbiome

  • Sauerkraut can help diversify and improve the composition of the gut microbiome, leading to various health benefits. (Healthline, 2023)

IBS symptoms

How to incorporate sauerkraut into one’s diet

Check the Ingredients

Option for unpasteurized

  • Look for sauerkraut that is labeled raw or naturally fermented to ensure it contains live probiotics.

Try to Eat Regularly

  • Aim to include sauerkraut in your diet a few times a week to reap the benefits. (Healthline, 2023)

Pair with Other Gut-Healthy Foods

  • Sauerkraut can be eaten alone or paired with other fermented foods, such as yogurt, kimchi, or chard, to promote gut health.

What to consider

Cabbage Allergy

  • Individuals who have a cabbage allergy or histamine intolerance should avoid sauerkraut.

Sodium

MAOI Medications

  • Consult with a doctor before adding sauerkraut to your diet if you are taking monoamine oxidase inhibitors (MAOIs).

Start small and learn how you like to eat sauerkraut, which can be as a condiment, side dish, or sandwich ingredient.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Body In Balance: Chiropractic, Fitness, and Nutrition


References

Shahbazi, R., Sharifzad, F., Bagheri, R., Alsadi, N., Yasavoli-Sharahi, H., & Matar, C. (2021). Anti-Inflammatory and Immunomodulatory Properties of Fermented Plant Foods. Nutrients, 13(5), 1516. https://doi.org/10.3390/nu13051516

Healthline. (2023). 8 Surprising Benefits of Sauerkraut (Plus How to Make It). https://www.healthline.com/nutrition/benefits-of-sauerkraut#nutrients

Medical News Today. (2023). What are the benefits of eating sauerkraut? https://www.medicalnewstoday.com/articles/health-benefits-of-sauerkraut

Wei, L., & Marco, M. L. (2025). The fermented cabbage metabolome and its protection against cytokine-induced intestinal barrier disruption of Caco-2 monolayers. Applied and environmental microbiology, e0223424. Advance online publication. https://doi.org/10.1128/aem.02234-24

National Institutes of Health Office of Dietary Supplements. (2023). Probiotics. Retrieved from https://ods.od.nih.gov/factsheets/Probiotics-Consumer/

National Institutes of Health. (2025). Probiotics. Retrieved from https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/

U.S. Department of Agriculture. (2018). Sauerkraut, canned, solids and liquids. Retrieved from https://fdc.nal.usda.gov/food-details/169279/nutrients

Muscles Retighten: Why Ongoing Care Is Essential

Why do the muscles retighten days or weeks later for individuals who have received massage or chiropractic adjustments?

Muscles Retighten

Muscles can retighten again days or weeks after chiropractic treatment and/or a massage. A few factors may cause this.

  • Muscle memory: The body’s natural tendency to return to its previous state of tension.
  • This includes all the unhealthy postures/positioning 
  • Delayed inflammatory response.
  • The body’s natural healing process
  • How muscles respond to manipulation
  • The need for ongoing maintenance of muscle health

After a massage, muscles can experience a temporary increase in soreness or tightness as the body heals from any minor damage or inflammation caused by the massage. Additionally, if the underlying issue causing muscle tightness is not addressed, the muscles may revert to their original state over time. (Cleveland Clinic, 2024)

Causes

Causes for muscles to retighten.

Underlying Issues

  • If the root cause of the muscle tightness is not addressed, such as unhealthy posture, injuries, repetitive motions, or muscle imbalances, it can lead to further complications.
  • In that case, the muscles may return to their original state after a few days or weeks.

Delayed Onset Muscle Soreness (DOMS)

  • For example, muscles feel sore after intense exercise, and individuals can also experience DOMS after a massage, especially if they are particularly tight or if it’s been a while since their last massage. (Healthline, 2020)

Delayed Inflammatory Response

  • Massage can sometimes cause microscopic tears or inflammation in muscle tissue, which triggers the body’s natural healing process.
  • This response can cause soreness and temporary tightness, as the body repairs the damaged tissue even after the initial massage. (Essential Chiropractic, 2025)

Muscle Memory

  • The body tends to revert to habitual patterns of muscle tension, especially if the underlying cause of the tightness isn’t addressed.
  • Muscles can retain how they were manipulated during the massage and may revert to their original tightness if they haven’t been consistently relaxed.

Muscle Guarding

  • The individual and body can subconsciously tense muscles to avoid pain or soreness, even after the massage. 
  • This muscle guarding can counteract the benefits of the massage and lead to a renewed cycle of tension. (Bhimani R. H., & Soomar D. 2019)

Muscle Health Maintenance

  • Regular Maintenance
  • Muscles need consistent care to maintain their optimal state of health and function.
  • Regular massages and other lifestyle changes, such as stretching and strengthening exercises, can help maintain muscle flexibility and reduce the likelihood of muscle tightness returning.

Individual Variation

  • Factors like the type of massage received, the frequency of massages, and individual body responses can all influence how long a massage’s benefits last. (Cleveland Clinic, 2024)

Massage Treatment

Muscles can retighten after a massage due to the body’s response to the pressure and manipulation during the treatment. This can include individual sensitivity to massage, the type of massage, and hydration levels, which can also play a role.

Type of Massage

  • Deep tissue massage, which focuses on specific muscle groups and applies deeper pressure, may cause more soreness than other types of massage.
  • Some individuals may be more sensitive to massage and experience soreness, even with a gentle massage. (Cleveland Clinic, 2024)

Muscle Fiber Manipulation

  • Deep tissue massage can break down spasms or microtears in muscle fibers, leading to soreness.
  • This is similar to the microscopic tears that occur during exercise, which are necessary for muscle repair and growth.

Dehydration

  • Individuals who are not adequately hydrated may experience increased soreness after a massage. (Cleveland Clinic, 2024)

Lactic Acid Buildup

  • During an intense massage, particularly deep tissue, lactic acid can build up in the muscles, leading to soreness and tightness. 
  • (Healthline, 2020)

Muscle Tensions

  • If the muscles were particularly tense or knotted before the massage, the manipulation could lead to soreness as the knots get worked out.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Secrets of Optimal Wellness


References

Cleveland Clinic. (2024). How to Relieve Muscle Soreness After a Massage. https://health.clevelandclinic.org/why-does-my-body-feel-worse-after-a-massage

Healthline. (2020). How to Relieve Sore Muscles After a Massage. https://www.healthline.com/health/sore-after-massage#causes-of-soreness

Essential Chiropractic and Physiotherapy. (2025). Muscle Ache After Massage: Common Causes and Relief. https://essentialchiropractic.co.uk/muscle-ache-after-massage-common-causes-and-relief/#:~:text=Post%2Dmassage%20soreness%20is%20a,hours%20as%20the%20muscles%20recover.

Bhimani, R. H., & Soomar, D. (2019). Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 44(5), 271–281. https://doi.org/10.1097/rnj.0000000000000151

Pace Running: How to Work with Pacers

Can pace running help runners concentrate on other things, like breathing, form, or mental toughness?

Pace Running

Running is a sport many participate in and doesn’t require any equipment—only quality running shoes. Running in races comes with various physical and mental challenges. Some runners enjoy running in races and marathons but want to perfect their abilities and techniques, become more consistent, finish in a certain time, or pass a personal record. This is where pace running or working with a pace runner can help achieve those goals.

What is a Pace Runner?

A pace runner, or pacer, is an experienced runner who can run at a set pace for a long time. The pacer sets the speed so the runner can focus on running. Pacers run in races or marathons to help set the pace for a runner or runners. There are different reasons why professional and amateur runners work with a pace runner. Professional runners often use pace runners to work on techniques and help reach new levels in their running, while amateur runners can work on improving their overall running abilities. There are three typical types of pacers.

Race Pacer

  • Pacers wear or carry signs to make it easier for the runners and can often run split times.
  • A split time is the time it takes to run a certain distance.
  • Typically, these pacers will run at an even pace.
  • Many marathons will have pace groups that run at a specific speed or pace throughout the race.
  • The pace groups will have runners running a set time so other runners can key off these runners.
  • There are typically set paces for a 3-hour marathon time up to a 6-hour marathon time.
  • Runners can use pacers to help them reach their goals without relying on technology, such as a smartwatch or GPS, to determine if they maintain the correct speed throughout the race.

Distance Pacer

  • Professional and non-professional runners who run long distances or ultramarathons may also use a pace runner to set a specific tempo.
  • Ultramarathons are any race with a distance longer than the standard marathon of 26.2 miles.
  • Because some ultramarathons can be as long as 50 to 100 miles, runners who choose to have a pacer often have several pacers at different sections to motivate them and help set the rhythm.

Record Pacer or Rabbit

  • A record pacer, also known as a rabbit, is a pacer who helps a professional runner set a new record.
  • A rabbit often leads the race for a predetermined distance at a predetermined pace.
  • Some races have multiple pacers at various distances.

How Are Pacers Used?

There are different reasons for having a pacer, but they are based on the runner’s goals.

  • A runner being paced runs directly behind a pacer or pacers.
  • A pacer can run any pace requested, but typically, the pace groups run at an even pace or with a slight negative split.
  • A negative split is when a runner runs the race’s second half faster than the first half.

How Do They Help?

  • A pacer can be helpful because it takes more energy to lead a race than to sit back and follow another runner.
  • The pacer is responsible for timing and establishing the tempo so runners only have to focus on running.
  • A pacer does more work setting the pace, which allows the runner being paced to relax and not stress about hitting the pace.

A study focused on elite athletes who used pacers. It found that running together at a realistic speed helped optimize and achieve finishing time goals. (Casado A. et al., 2021) However, not all elite events allow pacers to participate. Some championship events, like the Olympics and NCAA Championships, do not allow pacer runners.

Benefits

Benefits of running with a pacer.

Prevent Running Too Fast

  • When a race begins, runners can take off and start too fast.
  • Starting too quickly can negatively impact the runners, like losing energy and stamina.
  • A pacer can help start the race with a steady pace, keeping them from going out too fast or expending too much energy.

Maintain an Even Pace

  • Maintaining an even pace can be difficult throughout a long race or a marathon.
  • Having a pacer can relieve some stress and pressure.
  • A pacer can keep the runners on an even pace or negative splits versus going out too fast and losing energy.

Focus on the Race

  • Pacers help the runners stay focused on the race without worrying about how they are running or maintaining the right speed.
  • A pacer can help keep runners relaxed.

Motivating

  • Pacers can help motivate runners.
  • The pace runners may encourage individuals along the way and help them stay motivated to keep working toward their goal, especially when the hard parts come.

Disadvantages

Running with a pacer can sometimes be more stressful than beneficial, especially for amateur runners. A pacer or pace group can be helpful, but it also can create more stress for some amateur runners.

  • Sometimes, individuals realize the pacer is running too quickly for what they can handle.
  • Anxiety can present as not being able to keep up.
  • Other times, runners underestimate their abilities and run more slowly than their bodies can handle.
  • However, runners don’t have to stay with a pace group just because they started with them.
  • Individuals can run ahead.
  • Or if the group is too fast, the runner can slow down and join the slower-paced group behind them.
  • The key is to listen to your body and do what feels right.

Becoming a Pacer

An experienced runner who wants to be a pacer for a race can contact a running organization about becoming a pace runner.

  • Individuals need to be able to have consistent racing times.
  • Be able to run at a set speed for a long duration.
  • Most pacers will contact the race organization to apply for a certain pace.
  • Some pacers enjoy the thrill of running in a race and helping other runners meet their goals.
  • The runner’s goals and the type of event also influence who the pacer is.

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals can talk to local running experts or a running coach. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. We can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


The Difference of Using Custom Foot Orthotics


References

Casado, A., Hanley, B., Jiménez-Reyes, P., & Renfree, A. (2021). Pacing profiles and tactical behaviors of elite runners. Journal of Sport and Health Science, 10(5), 537–549. https://doi.org/10.1016/j.jshs.2020.06.011

Cornstarch: How to Replace Flour in Recipes

How can cornstarch be used instead of flour in recipes for individuals on a gluten-free diet who are looking for a flour alternative due to celiac disease or non-celiac gluten sensitivity?

flour table

Cornstarch Substitute

Flour is often used as a thickener or a coating in recipes. Pure cornstarch (made from corn) is a gluten-free flour substitute (Rai S., Kaur A., & Chopra C.S., 2018). However, some brands are not considered gluten-free.

Substitute for Flour

It’s easy to substitute cornstarch for flour when the recipe calls for a thickener, such as in gravies, sauces, pies, or coatings for fried foods. If flour is unavailable or individuals want to try a gluten-free alternative, cornstarch has a similar effect in these cooking applications.

However, individuals should be aware that it cannot be used as a substitute for flour in baked goods.

As a Thickener

Cornstarch can be a thickener in sauces, gravy, and pie fillings. (Bob’s Red Mill, 2020)

  • There is no taste of cornstarch.
  • However, foods will be more translucent.
  • This is because it is pure starch, while flour contains some protein.
  1. Cornstarch is not a 1:1 substitute for flour.
  2. Individuals should generally use one tablespoon for each 1 1/2 to 2 cups of flour for sauce/gravy for medium thickness. (The Denver Post, 2016)

When using cornstarch as a thickener:

  • Bring the mixture to a full boil for 1 minute, which allows the granules to swell to their maximum.
  • Reduce the heat as it thickens.
  • Overcooking can cause mixtures to thin when cooled.
  • Cook over medium-low to medium heat, as high heat can cause lumping.
  • Stir gently
  • Stirring vigorously can break down the mixture.
  • If more ingredients are needed, remove the pot from the heat and stir them quickly and gently.
  • Avoid freezing sauces or gravies since they won’t freeze well. (Cook’s Info, 2008)

How To Use

  • Use half as much cornstarch as you would flour.
  • For example, if the recipe calls for two tablespoons of flour, use one tablespoon of cornstarch.
  • If the recipe calls for 1/4 cup of flour, use 1/8 cup of cornstarch.
  • This is true for other starches, including arrowroot, potato, and tapioca. (Taste of Home, 2023)
  • Adding the cornstarch directly will cause it to clump and form lumps in the sauce that will be difficult to dissolve.
  • To avoid this, mix the cornstarch with cold water (1 tablespoon of cornstarch to 1 tablespoon of cold water) until it is dissolved.
  • Then pour the water/starch mixture/slurry into the mix.
  • Keep stirring as the mixture thickens. (Bon Appetit, 2020)

Cornstarch is not as effective as flour when thickening acidic sauces. It doesn’t work well with tomato, vinegar, or lemon juice sauces. It is also less effective than flour when thickening sauces made with fat, including butter or egg yolks. (The BC Cook Articulation Committee, 2015)

If the mixture contains too little liquid, the starch granules cannot absorb. This is also the case when there is more sugar than liquid, in which case, more liquid is needed to firm up the mixture.

Fried Dishes

Individuals can use cornstarch instead of flour to coat fried chicken, fish, or other fried dishes. It creates a crisper coating that better withstands sauces and absorbs less frying oil, resulting in a lower-fat meal. Tips for frying:

  • Try a 50/50 blend of cornstarch and gluten-free flour for a coating closer to wheat flour. (Bon Appetit, 2016)
  • Ensure there is a light, even cornstarch coating on the food.
  • Heavier coatings can get gummy.

Injury Medical Chiropractic and Functional Medicine Clinic

When cooking gluten-free, individuals may be able to continue to enjoy some of their favorite sauces by learning how to use cornstarch and other gluten-free thickeners instead of flour. As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


From Consultation to Transformation: Assessing Patients in a Chiropractic Setting


References

Rai, S., Kaur, A., & Chopra, C. S. (2018). Gluten-Free Products for Celiac-Susceptible People. Frontiers in Nutrition, 5, 116. https://doi.org/10.3389/fnut.2018.00116

Bob’s Red Mill. (2020). Baking with cornstarch: Everything you need to know. https://www.bobsredmill.com/articles/baking-with-cornstarch-everything-you-need-to-know

Denver Post. (2016). Cornstarch a good way to thicken gravy lightly. https://www.denverpost.com/2010/11/20/cornstarch-a-good-way-to-thicken-gravy-lightly/

Cook’s Info. (2008). Thickeners. https://www.cooksinfo.com/thickeners/

Taste of Home. (2023). Cornstarch vs. flour vs. arrowroot – when should you use which thickener? https://www.tasteofhome.com/article/best-thickener/

Bon Appetit. (2020). Cornstarch is a powerful tool that must be used responsibly. https://www.bonappetit.com/story/the-power-of-almighty-cornstarch

The BC Cook Articulation Committee. (2015). Understanding Ingredients for the Canadian Baker
Types of thickening agents. https://opentextbc.ca/ingredients/chapter/types-of-thickening-agents/

Bon Appetit. (2016). 4 brilliant ways to cook with cornstarch. https://www.bonappetit.com/story/cornstarch-uses-sauce-crispy-meat

Cauliflower Health Benefits You Should Know

Cauliflower is more than just a side dish. Discover exciting recipes and health benefits of cauliflower for a balanced diet.

Introduction

As a seasoned Nurse Practitioner with over 20 years of experience in physical and functional medicine, I’ve witnessed firsthand how diet and lifestyle choices profoundly influence overall health, from musculoskeletal integrity to gut function and immune resilience. One vegetable that has stood out for its remarkable versatility and potent health benefits is cauliflower. Often underestimated due to its pale appearance, cauliflower is a powerhouse of nutrients and bioactive compounds that can play a pivotal role in disease prevention, inflammation reduction, and metabolic optimization.

In this article, we’ll delve into cauliflower’s nutritional profile, examine its science-backed health benefits, and explore easy, delicious ways to incorporate this cruciferous gem into your daily diet. Whether your goal is reducing chronic inflammation, improving gut health, or supporting cardiovascular wellness, cauliflower deserves a starring role on your plate.


What Is Cauliflower?

Cauliflower (Brassica oleracea var. botrytis) is a cruciferous vegetable belonging to the Brassicaceae family, which includes broccoli, kale, Brussels sprouts, and cabbage. Native to the Mediterranean region, cauliflower is cultivated worldwide and comes in a variety of colors beyond the common white—such as green, purple, and orange—each offering unique phytonutrient profiles.

What makes cauliflower especially appealing in functional medicine is its low calorie and high nutrient density. It provides a rich array of vitamins, minerals, fiber, and powerful phytochemicals, making it an exceptional choice for individuals seeking to optimize health and prevent chronic disease.


Nutritional Value of Cauliflower

Cauliflower’s nutrient composition is a testament to its status as a superfood. Here’s what you’ll find in a one-cup (approximately 107 grams) serving of raw cauliflower:

  • Calories: 27 kcal
  • Carbohydrates: 5 g
  • Dietary Fiber: 2.1 g
  • Sugar: 2 g
  • Protein: 2.1 g
  • Fat: 0.3 g
  • Sodium: 32 mg
  • Potassium: 320 mg
  • Vitamin C: 85% of Daily Value (DV)
  • Vitamin B6: 10% of DV
  • Calcium: 2% of DV
  • Magnesium: 4% of DV
  • Iron: 2% of DV

Beyond these basics, cauliflower is rich in glucosinolates and sulforaphane—bioactive compounds known for their anti-inflammatory, anticancer, and neuroprotective properties. (Otoo & Allen, 2023)


How Cauliflower Supports Health

1. Boosts Immune Function and Antioxidant Defense

Cauliflower’s high vitamin C content enhances immune resilience by promoting white blood cell activity and protecting cells from oxidative stress. Its carotenoids and flavonoids provide additional antioxidant benefits, helping to neutralize free radicals and lower inflammation—a key contributor to chronic diseases like arthritis and cardiovascular disease. (Ahmed & Ali, 2013)

2. Promotes Gut Health and Regularity

Dietary fiber in cauliflower not only supports digestive regularity but also nourishes beneficial gut bacteria, enhancing microbiome diversity. Its glucosinolates (GLS) break down into isothiocyanates, compounds shown to have antimicrobial effects that help balance the gut ecosystem and reduce the risk of gastrointestinal disorders. (Sikorska-Zimny & Beneduce, 2021)

3. Aids in Weight Management and Metabolic Health

Low in calories but high in fiber and water content, cauliflower is an ideal food for satiety and weight control. Its fiber content slows digestion and promotes feelings of fullness, which can reduce overall caloric intake. Research also links cruciferous vegetable intake to improved insulin sensitivity and reduced risk of obesity-related metabolic disorders. (Madsen et al., 2023)

4. Reduces Inflammation and Oxidative Stress

Chronic inflammation and oxidative stress are central drivers of musculoskeletal pain, cardiovascular disease, and neurodegeneration. Sulforaphane—a potent compound found in cauliflower—has been shown to modulate inflammatory pathways and protect against oxidative cellular damage. Regular consumption of cauliflower may thus contribute to reduced markers of systemic inflammation. (Shandilya et al., 2022)

5. Potential Cancer-Protective Effects

Multiple epidemiological studies have linked cruciferous vegetable intake with a reduced risk of various cancers, including colorectal, lung, and breast cancers. Sulforaphane and other glucosinolate derivatives can induce phase II detoxification enzymes and promote apoptosis of cancer cells while inhibiting tumor growth. (Zhang et al., 2025)


Eating Right To Feel Better- Video


Cauliflower in Functional Medicine: Why It Matters

From a functional medicine perspective, food is medicine. Cauliflower’s ability to modulate gut health, reduce chronic inflammation, and support detoxification makes it invaluable in protocols aimed at healing leaky gut, balancing hormones, or managing autoimmune conditions. Moreover, because it is naturally gluten-free and low in carbohydrates, cauliflower is a favorite among individuals following ketogenic, paleo, or anti-inflammatory diets.


Simple and Delicious Cauliflower Recipes

Incorporating cauliflower into your diet doesn’t have to be boring. Here are some easy, nutrient-dense recipes that I often recommend to my patients:

1. Cauliflower Rice

A low-carb alternative to traditional rice, cauliflower rice is quick and versatile.

Ingredients:

  • 1 head of cauliflower
  • 1 tablespoon olive oil
  • 2 cloves garlic (minced)
  • Salt and pepper to taste

Instructions:

  • Pulse cauliflower florets in a food processor until rice-like consistency is achieved.
  • Sauté garlic in olive oil over medium heat.
  • Add cauliflower rice and cook for 5-7 minutes.
  • Season with salt and pepper. Serve as a side or a base for stir-fries.

2. Cauliflower Pizza Crust

Perfect for those avoiding gluten or refined carbs.

Ingredients:

  • 1 head of cauliflower
  • 1 egg
  • 1/2 cup shredded mozzarella
  • 1 teaspoon Italian seasoning
  • Salt and pepper to taste

Instructions:

  • Steam and mash cauliflower. Squeeze out excess moisture using cheesecloth.
  • Mix with egg, cheese, and seasonings to form a dough.
  • Shape into a pizza crust and bake at 400°F (200°C) for 15 minutes.
  • Add toppings and bake for an additional 10 minutes.

3. Cauliflower Buffalo Bites

A crowd-pleasing snack with all the flavor and none of the guilt.

Ingredients:

  • 1 head of cauliflower (cut into florets)
  • 1/2 cup all-purpose or gluten-free flour
  • 1/2 teaspoon garlic powder
  • 1/2 teaspoon paprika
  • 1 cup buffalo sauce

Instructions:

  • Toss florets with flour and spices.
  • Bake at 425°F (220°C) for 20 minutes.
  • Toss with buffalo sauce and bake for an additional 10 minutes.
  • Serve with celery sticks and a light ranch dip.

Conclusion: A Simple Step Toward Vibrant Health

Cauliflower is far more than a bland vegetable—it’s a therapeutic food with broad applications in physical and functional medicine. Its high nutrient density, anti-inflammatory properties, and gut-supportive compounds make it an excellent addition to any health-conscious individual’s diet.

In my clinical practice, I often emphasize the importance of personalized nutrition, and cauliflower frequently features in customized dietary protocols. By integrating this humble yet powerful vegetable into your meals, you can take meaningful steps toward reducing inflammation, optimizing gut health, and enhancing overall well-being.

For individuals seeking a holistic approach to health that marries dietary excellence with physical and functional therapies, working with experienced healthcare providers who understand the synergy between food and medicine is key. Together, we can build a roadmap that supports long-term wellness, starting with something as simple as adding more cauliflower to your plate.



Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals and incorporating cauliflower into their dietary needs. When asking important questions to our associated medical providers, we advise patients to incorporate numerous vegetables like cauliflower into their foods to provide energy and nutrients to their bodies in their customized treatment plan. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.


References

Ahmed, F. A., & Ali, R. F. M. (2013). Bioactive Compounds and Antioxidant Activity of Fresh and Processed White Cauliflower. BioMed Research International, 2013, 1-9. https://doi.org/10.1155/2013/367819

Madsen, H., Sen, A., & Aune, D. (2023). Fruit and vegetable consumption and the risk of hypertension: a systematic review and meta-analysis of prospective studies. Eur J Nutr, 62(5), 1941-1955. https://doi.org/10.1007/s00394-023-03145-5

Otoo, R. A., & Allen, A. R. (2023). Sulforaphane’s Multifaceted Potential: From Neuroprotection to Anticancer Action. Molecules, 28(19), 6902. https://doi.org/10.3390/molecules28196902

Shandilya, S., Kumar, S., Kumar Jha, N., Kumar Kesari, K., & Ruokolainen, J. (2022). Interplay of gut microbiota and oxidative stress: Perspective on neurodegeneration and neuroprotection. J Adv Res, 38, 223-244. https://doi.org/10.1016/j.jare.2021.09.005

Sikorska-Zimny, K., & Beneduce, L. (2021). The Metabolism of Glucosinolates by Gut Microbiota. Nutrients, 13(8), 2750. https://doi.org/10.3390/nu13082750

Zhang, X., Jia, Q., Jia, X., Li, J., Sun, X., Min, L., Liu, Z., Ma, W., & Zhao, J. (2025). <i>Brassica</i> vegetables—an undervalued nutritional goldmine. Horticulture Research, 12(2). https://doi.org/10.1093/hr/uhae302

Disclaimer

Pseudoarthrosis After Spinal Fusion Surgery Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis of the cervical and lumbar spine

Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:

  • Issues with the instruments used to stabilize the bone
  • Lack of bone growth
  • The number of vertebrae being fused.

The patient’s health and lifestyle play a role in failed fusions, which can include

  • Diabetes
  • Inflammatory health conditions increase the risk
  • Smoking
  • Long-term steroid use

In many cases, revision surgery is needed.

Surgery-Related

During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:

  • Plates
  • Rods
  • Screws
  1. The bone graft promotes growth between the two bones.
  2. The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
  3. The hardware goes inside, or internal fixation.
  4. Although rare, a severe spinal fracture or deformity may need external fixation.
  5. A rigid frame secured outside the body helps to stabilize the bones.

If the fusion fails, it could be caused by one or more of the following surgical issues:

Number of Vertebrae Being Fused

Hardware

  • The surgeon must carefully plan and use the right hardware.
  • The type of hardware used during a spinal fusion may influence bone healing.
  • The instruments can come loose or break, interfering with the fusion process.
  • Spinal osteoporosis, having thin, weak bones, can affect fixation.
  • Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.

Bone Graft

  • The type of bone graft used may affect the fusion.
  • For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
  • Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
  • The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.

Risk Factors

  • The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
  • Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)

The risk of pseudoarthrosis increases if the individual has any of the following: (Scoliosis Research Society, 2023)

  • Previous pseudoarthrosis
  • Obesity
  • Chronic steroid use
  • Malnutrition
  • Inflammatory diseases

Inflammatory conditions that can lead to bone loss and non-optimal bone healing include: (Torres H. M. et al., 2023)

  • Diabetes (Jiao H, Xiao E, & Graves DT, 2015)
  • Inflammatory bowel disease
  • Psoriasis
  • Rheumatoid arthritis
  • Chronic obstructive pulmonary disease/COPD
  • Periodontitis
  • Systemic lupus erythematosus/SLE

Symptoms

  • The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
  • If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
  • Rarely does a pinched nerve affect both arms.
  • The pain may return shortly after the procedure.
  • The pain may develop gradually or not appear for many months.
  • However, it’s more likely to appear after several months when the individual returns to their usual activities.

Diagnosis

  • The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
  • They’ll assess mobility and the type of movement that causes pain.
  • Then, they order diagnostic imaging to see the spine and identify the cause of pain.
  • Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.

Treatment

Treatment for pseudoarthrosis will likely start with:

  • Physical therapy
  • Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
  • Medication
  • Injections
  • If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
  • Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Enhancing Health Together


References

Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. https://doi.org/10.1186/s12891-024-07531-w

Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. https://doi.org/10.1055/s-0041-1722853

Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. https://doi.org/10.14444/4029

Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. https://doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1

Scoliosis Research Society. (2023). Pseudoarthrosis. https://www.srs.org/Patients/Conditions/Pseudoarthrosis

Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. https://doi.org/10.1007/s11914-023-00824-4

Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. https://doi.org/10.1007/s11914-015-0286-8

Pilates Nutrition for Enhanced Performance and Recovery

Many ask, what and when should you eat before, during, and after engaging in Pilates exercises?

Pilates Nutrition Plan

Pilates involves a lot of core work on the mat. However, it does not require a special diet. To fully utilize Pilates nutrition, individuals should consider what foods keep their bodies feeling the most balanced. A balanced nutrition plan can enhance Pilates practice by:

  • Providing sustained energy
  • Supporting muscle recovery
  • Promoting overall well-being

Pre-Pilates

Timing

  • Eat a light meal or snack 2-3 hours before a class or a smaller snack 30 minutes before.

Food Options

  • Eat complex carbohydrates like whole grains, fruits, and vegetables for sustained energy.

Avoid

  • Heavy, greasy, or spicy foods may cause discomfort during exercise.
  • Foods that will make you gassy or cause queasiness.

During the Workout

Complex carbohydrates and lean proteins, with a little healthy fat, are good pre-Pilates meals, as they sustain energy better than simple carbs or sugary snacks. (American Heart Association, 2024) Suggestions for a pre-Pilates meal.

  • Individuals can adjust the portion size.
  • A protein shake that uses fruit can be convenient.
  • Peanut butter on whole-grain bread offers a quick source of complex carbohydrates and protein.
  • Yogurt with fruit.
  • Small portion of oatmeal.

Because Pilates emphasizes using the abdominal muscles, individuals will want to ensure that any food they’ve eaten before their session is fully digested. Try to eat light before, like snacking on a banana or sipping on a smoothie for some carbohydrates for energy. Regardless of what is eaten, nutrition experts recommend waiting two to three hours after eating before exercising.

Maintain Hydration

  • Drink water and/or eat hydrating fruits throughout the day, especially before and during the workout or class.

After Working Out

Individuals want to ensure their bodies have enough nutrients to strengthen their muscles and replenish their energy. Try a protein green smoothie afterward or a light snack with lean protein like fish or chicken and carbohydrates like whole grains. The diet between workouts will depend on weight loss goals.

Timing

  • Consume a protein-rich snack or meal within 30-60 minutes after your class to aid muscle recovery.

Food Choices

  • Focus on protein for muscle repair and carbohydrates to replenish energy stores.

Hydration

  • Continue to hydrate to replenish fluids lost through perspiration.

While Pilates can complement cardiovascular exercise as part of a fat-burning workout program, health experts advise that losing weight will not come from exercise alone. Individuals will need to work on reducing their calorie intake overall. (Centers for Disease Control and Prevention, 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions.

  • Wellness & Nutrition: Personalized plans to optimize health and prevent disease.
  • Sports Injuries & Orthopedic Care: Treatment for sprains, strains, and complex injuries.
  • Chronic Pain Management: Non-invasive solutions for fibromyalgia, sciatica, and low back pain.
  • Personal Injury & Auto Accident Care: Tailored rehabilitation for whiplash, soft tissue injuries, and more.
  • Functional Medicine: Root-cause analysis for chronic disorders, incorporating nutrition, lifestyle, and environmental factors.
  • Neuromusculoskeletal Health: Care for neck pain, migraines, herniated discs, and scoliosis.

Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Home Exercises for Pain Relief


References

American Heart Association. (2024). Food as fuel before, during, and after workouts. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/food-as-fuel-before-during-and-after-workouts

Centers for Disease Control and Prevention. (2023). Tips for Maintaining Healthy Weight. Retrieved from https://www.cdc.gov/healthy-weight-growth/about/tips-for-balancing-food-activity.html?CDC_AAref_Val=https://www.cdc.gov/healthyweight/calories/index.html

The Throwing Motion and Its Impact on Performance

Can understanding the mechanics of the throwing motion help to understand why it may cause shoulder pain, the symptoms of a shoulder problem, the diagnosis, and the treatment options available?

Throwing a Ball and Shoulder Pain

The throwing motion is a complex shoulder movement that requires the mechanics of muscles, tendons, joints, ligaments, and bones. They all must move in a synchronized and stable pattern to move the shoulder joint. When these mechanics are interrupted or altered, inflammation can result in pain symptoms. (Wardell M., Creighton D., & Kovalcik C., 2022)

Throwing Motion

Distinct phases characterize the throwing motion:

  • The wind up
  • Cocking
  • Acceleration
  • Follow-through
  • Deceleration
  1. The rotator cuff and shoulder muscles sequentially guide the movements for effective throwing mechanics. (Wardell M., Creighton D., & Kovalcik C., 2022)
  2. The labrum stabilizes the ball in the socket of the shoulder.
  3. The shoulder blade rotation coordinates with the arm to ensure mobility. (Itoigawa Y. et al., 2023)

The throwing motion generates high torque and acceleration forces acting on the shoulder joint and the surrounding muscles, ligaments, and tendons.

Causes of Pain

Pain when throwing can come from the:

  • Shoulder blade
  • Shoulder joint – cartilage and labrum
  • Rotator cuff muscles and tendons
  • Nerves that control the muscles’ function 

The shoulder blade is attached to the upper back by ligaments, muscles, and tendons. The various muscles and tendons that control the movement of the shoulder blade impact movements. Abnormalities of any area can lead to shoulder dysfunction and pain when throwing. (Wardell M., Creighton D., & Kovalcik C., 2022) The most common is the tightness of the posterior shoulder capsule, causing a loss of normal internal rotation of the shoulder. If this is causing pain, individuals may notice that they can’t reach up as high on the side with the painful shoulder when reaching behind their back.

Symptoms

Whether an athlete or playing catch in the backyard, shoulder function abnormalities can cause significant pain. Some symptoms include.

Aching Pain

  • Often deep in the shoulder or extending down the upper arm.

Dead Arm

  • Lack of strength in the throwing motion.

Pain at Night

  • Pain can awaken you from sleep.

Diagnosis

Finding a healthcare provider familiar with sports injuries can be helpful. They can best determine if a structural abnormality needs to be addressed. (American Academy of Orthopaedic Surgeons, 2021)

Treatment

Most can improve with nonsurgical treatments. The earliest phase of treatment is resting the joint and reducing inflammation. Treatments can include:

  • Ice
  • Anti-inflammatory medications
  • Cortisone injection

Once the inflammation has subsided, the source of the discomfort can be addressed.

Physical Therapy

Therapy can include:

  • A structured shoulder stretching and strengthening program will help.
  • The physical therapist will focus on scapular mobility when managing shoulder joint problems.

Exercises may include: (American Academy of Orthopaedic Surgeons, 2024)

  • Stretching to improve internal rotation or any other lost motion can help allow a more normal throwing motion.
  • Strength exercises are often aimed at the rotator cuff, as these muscles initiate proper shoulder movements and stabilize the shoulder joint.
  • Maintaining flexibility and strength of the periscapular muscles (muscles that attach to the scapula bone) is important to ensure that the scapular movements are coordinated with the throwing motion.

Suppose improvements are not made within three months of therapy, or individuals can’t return to competitive sports within six months. In that case, the individual may need to return to their healthcare provider or see an orthopedic specialist who may recommend surgery. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions.

  • Wellness & Nutrition: Personalized plans to optimize health and prevent disease.
  • Chronic Pain Management: Non-invasive solutions for fibromyalgia, sciatica, and low back pain.
  • Personal Injury & Auto Accident Care: Tailored rehabilitation for whiplash, soft tissue injuries, and more.
  • Sports Injuries & Orthopedic Care: Treatment for sprains, strains, and complex injuries.
  • Functional Medicine: Root-cause analysis for chronic disorders, incorporating nutrition, lifestyle, and environmental factors.
  • Neuromusculoskeletal Health: Care for neck pain, migraines, herniated discs, and scoliosis.

Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges.

At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Lumbar Spine Injuries in Sports: Chiropractic Healing


References

Wardell, M., Creighton, D., & Kovalcik, C. (2022). Glenohumeral Instability and Arm Pain in Overhead Throwing Athletes: A Correlational Study. International journal of sports physical therapy, 17(7), 1351–1357. https://doi.org/10.26603/001c.39800

Itoigawa, Y., Koga, A., Morikawa, D., Kubota, A., Uehara, H., Maruyama, Y., Takazawa, Y., & Ishijima, M. (2023). Posterior shoulder stiffness was associated with shoulder pain during throwing in college baseball players: assessment of shear wave elastography. European journal of orthopaedic surgery & traumatology: orthopedie traumatologie, 33(4), 1237–1244. https://doi.org/10.1007/s00590-022-03286-z

American Academy of Orthopaedic Surgeons. (2021). Shoulder Injuries in the Throwing Athlete. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-injuries-in-the-throwing-athlete/

American Academy of Orthopaedic Surgeons. (2024). Shoulder Impingement/Rotator Cuff Tendinitis. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis

Understanding Nerve Conduction Velocity in Health Care

Should individuals experiencing nerve pain or various sensations get a nerve conduction velocity study to examine nerve health and function?

Nerve Conduction Velocity

A nerve conduction velocity (NCV) is a noninvasive test that measures the speed and strength of nerve stimulation using electrical probes placed on the skin. It’s used to diagnose nerve damage or disease, often alongside an EMG (electromyogram) to differentiate between nerve and muscle problems. It can also evaluate sensory issues, pain, and weakness of the extremities.

  • This test involves safe electrical shocks that can be slightly uncomfortable but not painful.
  • Nerve conduction velocity (NCV) measures the speed at which electrical impulses travel along a nerve fiber, which measures how quickly electrical signals travel through a nerve.
  • This information indicates nerve health and function.
  • Electromyography (EMG) is a nerve test that involves placing tiny needles into the muscles.
  • A slower NCV can indicate nerve injury or dysfunction.

Test Uses

Generally, the test is ordered to assess peripheral nerve diseases, those that connect from the muscles, organs, and skin to the spinal cord or brain. It can help identify the type and location of nerve damage.

  • Peripheral nerve conditions typically cause pain, sensory loss, tingling, or burning.
  • Mild weakness and diminished reflexes can be detected during a neurological examination.

Conditions

Nerve conduction studies are performed to help diagnose conditions.

  • Herniated disc disease
  • Sciatic nerve problems
  • Carpal tunnel syndrome
  • Guillain-Barré syndrome
  • Nerve damage (neuropathy), such as from diabetes, chemotherapy, or autoimmune disorders
  • Charcot-Marie-Tooth disease

Nerve compression

  • Many different conditions, including trauma, inflammation, and tumors, can compress one or more nerves.

Radiculopathy

  • Often described as a pinched nerve, radiculopathy can affect an arm or a leg, causing pain and weakness.

Peripheral Neuropathy

  • This nerve damage begins in the most distal nerves, those farthest from the center of the body, such as the toes and fingers. It is often due to chronic alcohol misuse, uncontrolled diabetes, nutritional deficits, and inflammatory diseases. (Ferdousi M. et al., 2020)

Carpal Tunnel Syndrome

  • Commonly caused by inflammatory diseases or overuse of the wrists, such as from assembly line work, carpal tunnel syndrome causes numbness, pain, and weakness of the fingers and hands. (Tada K. et al., 2022)

Ulnar neuropathy

  • This common condition causes arm pain and sensory changes, usually due to repetitive movements or a prolonged position that causes pressure on the ulnar nerve.

Guillain-Barré syndrome (GBS)

  • This inflammatory condition causes demyelination, or loss of the insulating covering around nerves, which results in leg weakness.
  • It begins in the motor nerves, which send signals to muscles in the legs. (Shibuya K. et al., 2022)
  • The inflammation travels to nerves of the upper body, often affecting the muscles that control breathing.
  • Respiratory support is necessary until the condition improves.

Chronic Demyelinating Polyneuropathy (CIDP)

  • This condition is a chronic, recurrent form of GBS that usually affects the legs and causes episodes of weakness.

ICU neuropathy

  • Metabolic changes, severe illness, and not moving enough can cause nerves to develop a pattern of weakness and sensory loss.

Myasthenia gravis (MG)

  • This autoimmune condition affects the junction between the nerves and the muscles.
  • Myasthenia gravis causes drooping eyelids and weakness of the arms and shoulders.

Amyotrophic lateral sclerosis (ALS)

  • ALS is a serious, degenerative disease affecting the spinal cord’s motor neurons.
  • Amyotrophic lateral sclerosis progresses rapidly, resulting in substantial weakness of muscles throughout the body.

How it’s Done

  • Surface electrodes are placed on the skin over nerves, and a small electrical current is applied to stimulate the nerve.
  • The time it takes for the electrical signal to travel between the electrodes is measured, and this time is used to calculate the NCV.

Values

Normal NCV values are generally between 50 and 70 meters per second. However, these values can vary depending on the nerve and the individual.

NCV Factors

Various factors can influence NCV.

  • Age
  • Sex
  • Medical conditions like diabetes

Interpretation

  • A slower NCV can indicate nerve damage or demyelination (loss of the myelin sheath, which insulates nerve fibers), while an EMG can help determine if the problem is with the nerve or the muscle.

Results

The results of NCV testing can be used to determine the type, severity, and location of nerve damage. The results will be ready in report form about a week after the test.

  • The test measures velocity (how fast a nerve transmits signals) and amplitude (how many nerve fibers were activated). (Tavee J. 2019)
  • The measurements are transmitted to a computer and shown as waves and numerical values.
  • The values are compared to a standard measurement based on the tested nerve.
  • The distance between the electrodes.
  • The person’s age.

Compared to the standard, the NCV results can identify certain patterns of nerve damage. (Tada K. et al., 2022) Outcomes include: (Tavee J. 2019)

  • If one or more nerves are affected.
  • If motor nerves (control movement), sensory nerves (transmit sensory signals), or both are affected.
  • Whether a nerve is blocked or damaged.
  • The severity of the damage.
  • The type of nerve damage
  • Axonal (damage to the nerve itself)
  • Demyelination (damage to the protective fatty layer around the nerve)

The results can help point to certain diagnoses.

Preparation Before the Test

Individuals will not need to change their diet before having an NCV. However, patients will be asked to avoid lotions or creams on their skin before the test. Individuals who are also having an EMG at the time of their NCV might be asked to stop taking medications or supplements that increase the risk of bleeding and bruising. If a healthcare provider says not to stop taking the medicines for health reasons, the patient might be warned that they could have some bruising after the EMG test.

  • NCV may advise against getting the test for those with electrical device implants.
  • Make sure your healthcare providers are aware of your whole medical history.

Injury Medical Chiropractic & Functional Medicine Clinic

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


Peripheral Neuropathy and Chiropractic Care


References

Ferdousi, M., Kalteniece, A., Azmi, S., Petropoulos, I. N., Worthington, A., D’Onofrio, L., Dhage, S., Ponirakis, G., Alam, U., Marshall, A., Faber, C. G., Lauria, G., Soran, H., & Malik, R. A. (2020). Corneal confocal microscopy compared with quantitative sensory testing and nerve conduction for diagnosing and stratifying the severity of diabetic peripheral neuropathy. BMJ open diabetes research & care, 8(2), e001801. https://doi.org/10.1136/bmjdrc-2020-001801

Tada, K., Murai, A., Nakamura, Y., Nakade, Y., & Tsuchiya, H. (2022). In Carpal Tunnel Syndrome, Sensory Nerve Conduction Velocities Are Worst in the Middle Finger Than in the Index Finger. Frontiers in Neurology, 13, 851108. https://doi.org/10.3389/fneur.2022.851108

Shibuya, K., Tsuneyama, A., Misawa, S., Suzuki, Y. I., Suichi, T., Kojima, Y., Nakamura, K., Kano, H., Ohtani, R., Aotsuka, Y., Morooka, M., Prado, M., & Kuwabara, S. (2022). Different patterns of sensory nerve involvement in chronic inflammatory demyelinating polyneuropathy subtypes. Muscle & Nerve, 66(2), 131–135. https://doi.org/10.1002/mus.27530

Tavee J. (2019). Nerve conduction studies: Basic concepts. Handbook of Clinical Neurology, 160, 217–224. https://doi.org/10.1016/B978-0-444-64032-1.00014-X