pain | ChiroMed

May 19, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN) allergies, body, dralexjimenez, health, histamine, histamine intolerance, immune system, intolerance, nonsurgical, pain, treatments, wellness

Histamine Intolerance and Its Impact on Health

Understand histamine intolerance and its effects on health. Discover symptoms and management strategies for better well-being.

Introduction

Introduction: A Holistic Approach to Health and Healing

At the intersection of chiropractic care and nurse practitioner expertise lies a powerful, integrative approach to healthcare that addresses the whole person—body, mind, and spirit. It offers unparalleled treatment options that optimize health outcomes by combining the hands-on, neuromusculoskeletal focus of chiropractic care with a nurse practitioner’s comprehensive, patient-centered medical management. This article explores how this dual licensure enhances interdisciplinary treatments, expands the scope of practice, and provides evidence-based solutions for conditions such as histamine intolerance, chronic pain, and systemic inflammation. With a foundation in randomized controlled trials (RCTs) and cohort studies, we’ll highlight the benefits of this integrative model for college-educated readers seeking advanced, holistic care.

The Role of Chiropractic Care in Optimal Health

Chiropractic care focuses on diagnosing, treating, and preventing neuromusculoskeletal disorders, emphasizing the spine’s role in overall health. By correcting spinal misalignments (subluxations), chiropractors restore proper nerve function, reduce pain, and enhance the body’s natural healing processes. Key benefits include:

Pain Management: Chiropractic adjustments are highly effective for conditions like low back pain, neck pain, and headaches. A 2017 meta-analysis of RCTs found that spinal manipulative therapy (SMT) significantly reduces chronic low back pain intensity compared to sham treatments (Coulter et al., 2017).
Improved Mobility: Adjustments enhance joint function, benefiting patients with arthritis or post-injury stiffness. A 2020 cohort study demonstrated enhanced range of motion in patients with osteoarthritis receiving chiropractic care (Goertz et al., 2020).
Reduced Inflammation: Chiropractic care modulates inflammatory cytokines, supporting systemic health. A 2018 RCT showed decreased pro-inflammatory markers like IL-6 levels after SMT (Teodorczyk-Injeyan et al., 2018).
Holistic Wellness: By addressing biomechanical dysfunction, chiropractors promote balance in the autonomic nervous system, improving sleep, digestion, and stress resilience.

Chiropractic care aligns with restoring structural integrity to empower the body’s innate healing capacity.

The Nurse Practitioner’s Role: Comprehensive Medical Management

As a nurse practitioner (NP), many bring advanced medical training to diagnose and manage a wide range of acute and chronic conditions. NPs are licensed to perform physical exams, order diagnostic tests, prescribe medications, and develop treatment plans, offering a broader scope than chiropractic care alone. Key benefits include:

Systemic Health Management: NPs address conditions like histamine intolerance, autoimmune disorders, and hormonal imbalances through evidence-based interventions. A 2021 cohort study highlighted NPs’ efficacy in managing chronic conditions like diabetes and hypertension (Poghosyan et al., 2021).
Functional Medicine Expertise: NPs trained in functional medicine, as emphasized on www.chiromed.com, identify root causes of dysfunction, such as gut dysbiosis or nutritional deficiencies, using lab testing and personalized protocols.
Patient-Centered Care: NPs prioritize education and shared decision-making, empowering patients to take charge of their health. A 2019 RCT showed improved patient satisfaction and adherence with NP-led care compared to physician-led models (Laurant et al., 2019).
Preventive Strategies: NPs develop lifestyle interventions to prevent disease progression, such as dietary modifications for histamine intolerance or stress management for adrenal health.

The NP scope complements chiropractic care by addressing systemic issues that may exacerbate neuromusculoskeletal symptoms, creating a comprehensive care model.

Synergistic Benefits of Dual Licensure

The combination of chiropractic and NP credentials allows Dr. Jimenez to offer interdisciplinary treatments that bridge structural and systemic health. This integrative approach is particularly effective for complex conditions like histamine intolerance, chronic pain, and inflammatory disorders. Below, we explore how this dual licensure enhances patient outcomes.

1. Comprehensive Assessment and Diagnosis

A dual-licensed provider can perform a thorough evaluation that integrates biomechanical and medical perspectives. For example:

Chiropractic Assessment: Identifies spinal subluxations, postural imbalances, or joint dysfunction contributing to pain or neurological symptoms. A 2016 RCT confirmed that chiropractic evaluations accurately detect pain-related subluxations (Triano et al., 2016).
NP Assessment: Orders lab tests (e.g., gut microbiome panels, DAO enzyme levels) to uncover systemic issues like histamine intolerance or hormonal imbalances. A 2020 cohort study validated the use of functional lab testing in diagnosing root causes of chronic symptoms (Comas-Basté et al., 2020).

By synthesizing these findings, health care professionals can create a holistic treatment plan that addresses structural misalignments and underlying physiological dysfunctions.

2. Interdisciplinary Treatment Options

The expanded scope of practice enables a wide range of evidence-based interventions, tailored to the patient’s needs. Examples include:

Spinal Manipulative Therapy (SMT) reduces pain and inflammation, as supported by a 2017 RCT showing its efficacy for acute low back pain (Paige et al., 2017).
Soft Tissue Therapy: Techniques like myofascial release alleviate muscle tension, improving outcomes for fibromyalgia patients, per a 2019 cohort study (Castro-Sánchez et al., 2019).
Nutritional Counseling: NPs prescribe low-histamine diets or DAO-supportive nutrients (e.g., vitamin C, B6) to manage histamine intolerance. A 2021 RCT demonstrated reduced symptoms with low-histamine diets (Sánchez-Pérez et al., 2021).
Lifestyle Interventions: Stress management techniques, such as mindfulness or yoga, modulate the autonomic nervous system, supported by a 2018 RCT showing reduced cortisol levels (West et al., 2018).
Pharmacological Support: When necessary, NPs prescribe medications (e.g., antihistamines, low-dose naltrexone) to stabilize symptoms, guided by clinical guidelines and patient response.

This integrative approach ensures that patients receive both immediate relief and long-term solutions.

3. Targeted Management of Histamine Intolerance

Histamine intolerance, as described in the original post, is a complex condition involving immune, gastrointestinal, and neurological systems. A dual-licensed provider is uniquely equipped to address it through:

Chiropractic Interventions: Adjustments reduce sympathetic nervous system overactivity, which can exacerbate histamine release. A 2020 RCT showed SMT decreases sympathetic tone, improving immune regulation (Colombi et al., 2020).
NP Interventions: Functional medicine protocols, such as gut-healing diets (e.g., bone broth, glutamine) and DAO supplementation, address root causes like gut dysbiosis. A 2022 cohort study linked gut microbiome restoration to reduced histamine symptoms (Dicks, 2022).
Dietary Guidance: NPs design low-histamine meal plans, incorporating anti-inflammatory foods like turmeric and quercetin, as supported by a 2021 RCT (Sánchez-Pérez et al., 2021).
Hormonal Balance: NPs address estrogen-driven DAO inhibition, common in women with PMS or PCOS, using targeted supplements like magnesium, per a 2019 cohort study (Parazzini et al., 2019).

This multifaceted approach alleviates symptoms and restores systemic balance, preventing recurrence.

4. Enhanced Pain and Inflammation Management

Chronic pain and inflammation often stem from both structural and systemic issues. The dual-licensed approach excels in:

Chiropractic Care: SMT and soft tissue therapies reduce pain signaling and inflammation, as evidenced by a 2018 RCT showing decreased IL-6 levels post-adjustment (Teodorczyk-Injeyan et al., 2018).
NP Care: Functional medicine addresses inflammatory triggers (e.g., food sensitivities, heavy metal toxicity) through detox protocols and anti-inflammatory diets. A 2020 cohort study linked dietary interventions to reduced CRP levels (Calder et al., 2020).
Integrative Modalities: Combining adjustments with acupuncture or low-level laser therapy, as offered at www.chiromed.com, enhances pain relief, per a 2019 RCT (Chou et al., 2019).

This synergy ensures comprehensive pain management, addressing both symptoms and causes.

5. Personalized, Preventive Care

The dual licensure model emphasizes bio-individuality, tailoring treatments to the patient’s unique physiology. Preventive strategies include:

Chiropractic Maintenance: Regular adjustments prevent subluxations and maintain optimal nerve function, as supported by a 2018 cohort study (Schneider et al., 2018).
NP-Led Functional Medicine: Ongoing lab monitoring and lifestyle coaching prevent disease progression. A 2021 RCT showed improved health markers with NP-led preventive care (Poghosyan et al., 2021).
Patient Education: Both disciplines empower patients with tools for self-care, from ergonomic advice to stress reduction techniques, fostering long-term wellness.

Fighting Inflammation Naturally-Video

Case Study: Managing Histamine Intolerance Holistically

Consider a 40-year-old female patient presenting with bloating, migraines, and hives, suspecting histamine intolerance. Dr. Jimenez’s approach might include:

Chiropractic Evaluation: Assess for cervical subluxations contributing to migraines. Adjustments reduce nerve irritation, as shown in a 2019 RCT (Bryans et al., 2019).
NP Diagnostic Workup: Order a gut microbiome panel and DAO enzyme test to confirm histamine intolerance, per Comas-Basté et al. (2020).
Treatment Plan:
- SMT to alleviate migraines and improve autonomic balance.
- Low-histamine diet with DAO-supportive nutrients (vitamin C, B6).
- Probiotics restore gut health and reduce histamine production.
- Stress management techniques to lower cortisol-driven histamine release.
Follow-Up: Monitor symptoms and lab markers, adjusting the plan as needed.

This integrative strategy resolves symptoms while addressing root causes, exemplifying the power of dual licensure.

Conclusion: Empowering Health Through Integration

The dual licensure of a chiropractor and nurse practitioner offers a transformative approach to healthcare. This model addresses both structural and systemic aspects of health by integrating chiropractic adjustments with functional medicine, nutritional counseling, and advanced diagnostics. Conditions like histamine intolerance, chronic pain, and inflammation benefit from this synergy, as evidenced by RCTs and cohort studies. Patients find a holistic, evidence-based path to wellness that empowers them to thrive. This integrative approach is a beacon of hope and healing for those seeking comprehensive care that honors bio-individuality.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals with histamine intolerances affecting their bodies. When asking important questions to our associated medical providers, we advise patients to incorporate small changes in their routine to reduce the chances of aggravating histamine symptoms from affecting the body. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Bryans, R., et al. (2019). Evidence-based guidelines for chiropractic management of headaches. Journal of Manipulative and Physiological Therapeutics.
Calder, P. C., et al. (2020). Nutrition and inflammation: A cohort study. Nutrients.
Castro-Sánchez, A. M., et al. (2019). Myofascial release for fibromyalgia: A cohort study. Pain Medicine.
Chou, R., et al. (2019). Nonpharmacologic therapies for chronic pain: An RCT. Annals of Internal Medicine.
Colombi, A., et al. (2020). Spinal manipulation and autonomic nervous system: An RCT. Journal of Chiropractic Medicine.
Comas-Basté, O., et al. (2020). Histamine intolerance: A cohort study. Nutrients.
Coulter, I. D., et al. (2017). Spinal manipulative therapy for chronic low back pain: A meta-analysis. Spine Journal.
Dicks, L. (2022). Gut microbiome and histamine regulation: A cohort study. Frontiers in Microbiology.
Goertz, C. M., et al. (2020). Chiropractic care for osteoarthritis: A cohort study. Journal of Orthopaedic & Sports Physical Therapy.
Laurant, M., et al. (2019). Nurse practitioner-led care: An RCT. Health Affairs.
Paige, N. M., et al. (2017). Spinal manipulative therapy for acute low back pain: An RCT. JAMA.
Parazzini, F., et al. (2019). Magnesium for PMS: A cohort study. European Journal of Obstetrics & Gynecology.
Poghosyan, L., et al. (2021). Nurse practitioner management of chronic conditions: A cohort study. Journal of the American Association of Nurse Practitioners.
Sánchez-Pérez, S., et al. (2021). Low-histamine diet for histamine intolerance: An RCT. Clinical Nutrition.
Schneider, M., et al. (2018). Chiropractic maintenance care: A cohort study. Chiropractic & Manual Therapies.
Teodorczyk-Injeyan, J. A., et al. (2018). Spinal manipulative therapy and inflammation: An RCT. Journal of Manipulative and Physiological Therapeutics.
Triano, J. J., et al. (2016). Chiropractic evaluation of subluxations: An RCT. Spine.
West, J., et al. (2018). Mindfulness for stress reduction: An RCT. Stress and Health.

Disclaimer

May 2, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care body, cervical, chiropractic care, dralexjimenez, health, migraines, neck, neck pain, nonsurgical, pain, treatment, wellness

Migraines & Neck Pain: Understanding the Connection

Find out how migraines and neck pain can disrupt your day and explore solutions to help you regain your comfort and peace.

Introduction

As a Nurse Practitioner with over 20 years of experience in physical and functional medicine, I’ve seen firsthand how chronic migraines—especially those linked with neck pain—can derail lives. Migraines are more than just severe headaches; they are complex neurological events often triggered by musculoskeletal dysfunction, stress, inflammation, and poor posture.

What’s often overlooked in traditional care models is the close relationship between cervical spine health and migraine activity. By integrating chiropractic care, postural retraining, and functional nutrition, we can significantly reduce migraine frequency and severity for many patients.

In this comprehensive post, we’ll explore:

The anatomical and physiological link between neck pain and migraines
The role of fibromyalgia in exacerbating migraine symptoms
Evidence-based chiropractic interventions
Postural and ergonomic corrections
Anti-inflammatory nutritional strategies

The Link Between Neck Pain and Migraines: Cervicogenic and Neurovascular Overlap

Patients often describe their migraine episodes beginning with a deep ache or stiffness in the neck, which gradually radiates toward the skull. This isn’t coincidental—it’s anatomical. Many migraines are cervicogenic in origin, meaning they arise from dysfunctions in the cervical spine.

The Cervical Trigeminovascular Connection

Cervicogenic headaches and migraines share overlapping pathways, particularly involving the trigeminocervical complex—a convergence of sensory nerves from the cervical spine and trigeminal nerve that transmits head and facial pain. Misalignment, muscular tension, or inflammation in this area can trigger the trigeminal-autonomic reflex, activating symptoms like:

Throbbing head pain
Light and sound sensitivity
Visual aura
Nausea

According to Vicente et al. (2023), activation of this reflex and extracranial autonomic involvement may underlie migraine generation when cervical structures are compromised. This suggests that structural or functional issues in the neck—such as joint hypomobility or myofascial tension—can act as primary migraine triggers.

Common Migraine-Associated Neck Pain Triggers

Cervical spine misalignment
Postural kyphosis and forward head posture
Muscular tension from occupational strain or emotional stress
TMJ dysfunction
Inadequate sleep or poor sleep posture

Fibromyalgia: An Amplifier of Migraines and Neck Pain

Patients with fibromyalgia are particularly susceptible to migraines due to central sensitization—a phenomenon in which the central nervous system becomes hypersensitive to stimuli.

In these patients, mitochondrial dysfunction plays a key role. As Janssen et al. (2021) highlight, both fibromyalgia and migraines are associated with impaired cellular energy metabolism. Symptoms in fibromyalgia patients often include:

Intensified migraine episodes
Musculoskeletal tenderness in the neck, trapezius, and occiput
Sleep disturbances and fatigue
Amplified pain response to touch (allodynia)

Understanding this connection allows for more targeted and effective treatment plans. Interventions must address not just musculoskeletal alignment but also systemic inflammation and nervous system regulation.

Tension Headaches Explained- Video

Holistic and Functional Interventions for Migraine Management

1. Chiropractic Care and Manual Therapy: Restoring Cervical Balance

Chiropractic interventions can be transformative for patients experiencing migraines related to neck dysfunction. Techniques such as cervical spine manipulation, soft tissue release, and muscle energy techniques (METs) help restore balance and reduce pain signaling.

Key Chiropractic Techniques:

Suboccipital Release: Alleviates deep muscle tension that compresses the greater occipital nerve
Cervical Mobilization: Increases joint range of motion and reduces localized inflammation
Myofascial Release: Targets the tight fascia and deep muscle layers in the upper back and neck
Instrument-Assisted Soft Tissue Mobilization (IASTM): Enhances blood flow and breaks down fibrotic tissue

Research by Mayo & Keating (2023) demonstrates that chiropractic spinal manipulation can significantly reduce migraine frequency and symptom duration, especially when combined with ergonomic education and exercise.

2. Postural Retraining and Ergonomics: Reducing Structural Strain

Modern lifestyle habits, such as prolonged screen use and poor workstation design, contribute significantly to cervical dysfunction and subsequent migraines.

Postural Interventions:

Craniocervical Flexion Exercises: Strengthen deep neck flexors and reduce forward head posture
Scapular Stabilization Routines: Reinforce shoulder and thoracic posture
Workstation Ergonomic Adjustments: Monitor elevation, lumbar support, and keyboard positioning

A 2021 study by de Almeida Tolentino et al. confirms that correcting head and neck posture can significantly reduce the frequency of migraines and improve functional disability scores in migraine sufferers.

3. Anti-Inflammatory Nutrition: Healing from Within

Nutritional strategies play a crucial role in modulating inflammation and stabilizing the nervous system. Many patients experience relief by identifying and avoiding dietary migraine triggers such as:

Aged cheeses
Processed meats (high in nitrates)
MSG, aspartame, and high-sugar foods
Alcohol, especially red wine

Functional Nutrition Recommendations:

Elimination Diets: Help identify food triggers and reduce systemic inflammation (Gazerani, 2020)
Magnesium Supplementation: Reduces cortical spreading depression and improves vascular tone (Shin et al., 2020)
Omega-3 Fatty Acids: Found in fatty fish, flaxseed, and chia, these combat neuroinflammation
Riboflavin (Vitamin B2): Shown to reduce the frequency of migraines when taken consistently
CoQ10: Improves mitochondrial function and energy production in the brain

Integrating these supplements and dietary shifts can offer long-term, sustainable relief by addressing underlying metabolic and neurological dysfunctions.

Integrated Care Planning: The Functional Medicine Model

In my clinical practice, treating migraines associated with neck pain involves more than adjusting the spine or prescribing a supplement—it requires a systems-based approach.

A Sample Care Plan May Include:

Initial chiropractic assessment and spinal X-rays (if indicated)
Trigger point mapping and musculoskeletal evaluation
Nutritional intake analysis with elimination diet guidance
Prescription of cervical mobility and posture exercises
Functional labs to assess inflammatory markers and micronutrient status
Co-management with neurologists for medication tapering (when appropriate)

The goal is to transition patients from episodic crisis management to proactive wellness, reducing reliance on pharmaceuticals and emergency interventions.

Empowering Patients Through Education and Collaboration

One of the most rewarding aspects of integrative care is educating patients about how their lifestyle, posture, diet, and spinal alignment interact to affect migraine frequency and severity.

By understanding the why behind their symptoms, patients are more empowered to:

Recognize and avoid migraine triggers
Adhere to treatment protocols
Participate in preventive strategies like exercise and stress reduction

When patients are viewed not just as symptoms but as whole individuals, outcomes dramatically improve. As we tailor care to their unique physiology and environment, we foster long-term healing—not just temporary relief.

Conclusion: Migraines and Neck Pain—An Opportunity for Functional Healing

The connection between migraines and neck pain is more than coincidental—it’s a deeply interwoven neurovascular and musculoskeletal relationship. As functional and physical medicine providers, we have the opportunity to address this relationship holistically.

Through chiropractic care, ergonomic corrections, anti-inflammatory nutrition, and nervous system regulation, we can guide patients toward a life with fewer migraines, improved neck mobility, and greater vitality.

By looking beyond the head and acknowledging the role of the cervical spine and systemic health, we not only reduce pain—we restore function, purpose, and quality of life.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with neck pain associated with migraines. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce migraines from reappearing and causing neck pain. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Aguilar-Shea, A. L., Membrilla Md, J. A., & Diaz-de-Teran, J. (2022). Migraine review for general practice. Aten Primaria, 54(2), 102208. https://doi.org/10.1016/j.aprim.2021.102208

Al Khalili, Y., Ly, N., & Murphy, P. B. (2025). Cervicogenic Headache. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939639

de Almeida Tolentino, G., Lima Florencio, L., Ferreira Pinheiro, C., Dach, F., Fernandez-de-Las-Penas, C., & Bevilaqua-Grossi, D. (2021). Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol, 21(1), 249. https://doi.org/10.1186/s12883-021-02290-w

Di Antonio, S., Arendt-Nielsen, L., & Castaldo, M. (2023). Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract, 66, 102817. https://doi.org/10.1016/j.msksp.2023.102817

Gazerani, P. (2020). Migraine and Diet. Nutrients, 12(6). https://doi.org/10.3390/nu12061658

Janssen, L. P., Medeiros, L. F., Souza, A., & Silva, J. D. (2021). Fibromyalgia: A Review of Related Polymorphisms and Clinical Relevance. An Acad Bras Cienc, 93(suppl 4), e20210618. https://doi.org/10.1590/0001-3765202120210618

Jara Silva, C. E., Joseph, A. M., Khatib, M., Knafo, J., Karas, M., Krupa, K., Rivera, B., Macia, A., Madhu, B., McMillan, M., Burtch, J., Quinonez, J., Albert, T., & Khanna, D. (2022). Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus, 14(8), e27830. https://doi.org/10.7759/cureus.27830

Mayo, Z., & Keating, C. (2023). Manual Therapy and Exercise for the Management of Chronic Neck Pain With Multiple Neurovascular Comorbidities: A Case Report. Cureus, 15(3), e36961. https://doi.org/10.7759/cureus.36961

Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and Pain. Nutrients, 12(8). https://doi.org/10.3390/nu12082184

Vicente, B. N., Oliveira, R., Martins, I. P., & Gil-Gouveia, R. (2023). Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine. Diagnostics (Basel), 13(4). https://doi.org/10.3390/diagnostics13040590

Disclaimer

May 2, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Electroacupuncture, Physio acupuncture, back, chiropractic, Clinic, decompression, health, Injury, massage, medical, pain, position, relieve, spine, supine, wellness

Supine Position Explained: Benefits and Uses

For individuals experiencing back pain, can lying in the supine position help bring relief?

Supine Position

The supine position describes the body’s position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It’s commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)

Medical Uses

Examinations

Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)

Procedures

It’s also used for various procedures, such as lumbar punctures and injections. (Steris Healthcare, 2025)

Surgery

Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures.
It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)

Overall Health

Natural Position

Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.

Back Pain Relief

Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)

Acid Reflux

However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)

Sleep Apnea

The supine position can worsen sleep apnea in some individuals.

Clinical Uses

A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
Many bed exercises begin in this position for rehabilitation.

Back Care

Here are a few recommendations to relieve low back pain using the supine position.

First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
Start breathing and relaxing, allowing the tension to drain out of the muscles.
In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
At that point, the fingertips should feel the transverse abdominal muscle engage.
Release and repeat 10 times.

After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.

For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.

Variations

Lawn Chair Position

This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.

Frog-Leg Position

The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 2025)

Injury Medical Chiropractic & Functional Medicine Clinic

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

Thoracic Spine Pain

References

ScienceDirect. (2009). Supine Position. Morrey’s The Elbow and Its Disorders (Fourth Edition), 567-577. https://doi.org/https://doi.org/10.1016/B978-1-4160-2902-1.50042-5

Nurse.com. (2024). What Is Supine Position? https://www.nurse.com/nursing-resources/definitions/what-is-supine-position/#:~:text=During%20routine%20physical%20examinations%2C%20the,easier%20to%20perform%20comprehensive%20assessments.

STERIS. (2025). The Complete Guide to Patient Positioning. https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning#:~:text=The%20most%20common%20position%20used,and%20elevating%20the%20sternal%20notch.

MedicalNewsToday. (2022). What is the supine position? https://www.medicalnewstoday.com/articles/supine-position

Aurora BayCare Medical Center. (N.D.). Lumbar stabilization hooklying position. https://ahc.aurorahealthcare.org/fywb/baycare/x06913bc.pdf

April 25, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Athletes, Sporting acupuncture, arm, ball, chiropractic, Clinic, decompression, health, Injury, massage, nurse, nutrition, pain, rehabilitation, shoulder, sports, throwing, wellness

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

The rotator cuff and shoulder muscles sequentially guide the movements for effective throwing mechanics. (Wardell M., Creighton D., & Kovalcik C., 2022)
The labrum stabilizes the ball in the socket of the shoulder.
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 Medicine, Acupuncture, Electro-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

April 9, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Exercises body, calisthenics, chiropractic, dralexjimenez, exercise, health, muscle, muscle pain, pain, wellness, workout

Calisthenics: Transform Your Body Naturally

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

Introduction

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

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

Understanding Musculoskeletal Disorders: A Functional Medicine Perspective

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

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

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

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

Why Non-Surgical Interventions Matter

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

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

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

Calisthenics: The Foundation of Functional Movement

What Is Calisthenics?

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

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

Neuromuscular integration
Proprioceptive feedback
Core stabilization
Functional joint loading

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

Calisthenics and Health Optimization

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

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

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

Can Core Exercises Help With Back Pain?-Video

Chiropractic Care: Restoring Biomechanical Integrity

What Does Chiropractic Care Do?

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

Key benefits include:

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

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

The Synergy Between Calisthenics and Chiropractic Care

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

Key Integration Strategies:

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

Evidence-Based Calisthenics for Musculoskeletal Pain

Calisthenics for Low Back Pain: 4 Foundational Exercises

1. Glute Bridge

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

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

2. Bird-Dog

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

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

3. Wall Sit

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

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

4. Pelvic Tilt

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

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

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

Calisthenics in Functional Rehabilitation Protocols

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

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

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

Case Example: Chronic Low Back Pain

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

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

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

Final Thoughts: Empowering Movement for Long-Term Health

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

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

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

Injury Medical & Functional Medicine Clinic

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

References

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

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

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

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

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

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

Disclaimer

April 5, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Therapy acupuncture, buttock, chiropractic, Clinic, decompression, down, foot, hamstring, Injury, leg, medical, nerve, numbness, pain, radiating, relief, sciatic, syndrome, thigh, tightness

Hamstring Syndrome Relief for Sciatic Nerve Pain

Individuals dealing with pain in the buttocks and in the back of the thigh, along with numbness and tingling down to the bottom of the foot, may be experiencing hamstring syndrome, a condition caused by pressure on the sciatic nerve. What is the recommended treatment?

Hamstring-Syndrome Relief

The hamstrings are three muscles in the back of the thigh, extending from the pelvis or upper thigh across the back of the knee to the leg. This muscle group is important for bending the knee, straightening the hip, and stabilizing the knee. The sciatic nerve is a large nerve that runs from the lower back down the legs. It usually passes near or through these muscles, and the pelvis then runs under these muscles in the thigh. Hamstring syndrome refers to pain in the buttock and back of the thigh, often radiating down the leg, caused by compression or irritation of the sciatic nerve at the hamstring-insertion point on the ischial tuberosity, typically due to tight or scarred tissue. (Sakari Orava, 1997)

Pain Location

The pain is primarily felt in the buttock and back of the thigh, sometimes extending down the leg. It’s characterized by pressure on the sciatic nerve, which runs through the buttock and into the back of the thigh, where it supplies the hamstring muscles. (Kaiser Permanente, 2024)

Mechanism

This pressure can occur due to: (Sakari Orava, 1997) (Kaiser Permanente, 2024)

Fibrotic Bands

Tight, tendon-like, or scarred bands of tissue at the hamstring’s insertion point/ischial tuberosity can irritate the sciatic nerve.

Compression

These bands can compress the nerve, especially when sitting or during activities that involve hip flexion and knee extension.

Traction

The sciatic nerve can also be stretched or irritated by the hamstring tendons.

Symptoms

Pain in the buttock and back of the thigh may radiate down the leg.
Pain that is worse when sitting, stretching the hamstrings, or during activities like running. (Puranen J. & Orava S. 1988)
Numbness or tingling in the back of the leg

Differential Diagnosis

It’s important to differentiate hamstring syndrome from other conditions that could be causing similar symptoms, including:

Piriformis syndrome
Ischiogluteal bursitis
Hamstring muscle strains

Treatment

Hamstring syndrome relief may consist of the following:

Conservative

Initial treatment focuses on rest, ice, stretching, and over-the-counter pain relievers.

Physical Therapy

Exercises to strengthen and stretch the hip and hamstring muscles can be beneficial. (Zion Physical Therapy, 2023)

Injections

In some cases, injections with cortisone and numbing medicine may be used to reduce nerve inflammation and pain. (Lower Limb Surgery, 2024)

Surgery

In severe cases, surgery may be necessary to release the compressing bands and free the sciatic nerve. (Lower Limb Surgery, 2024)

Injury Medical Chiropractic & Functional Medicine Clinic

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

Sciatica: Causes, Symptoms and Tips

References

Orava, Sakari. (1997). Hamstring syndrome. Operative Techniques in Sports Medicine, 5(3). https://doi.org/https://doi.org/10.1016/S1060-1872(97)80035-4.

Kaiser Permanente. (2024). Hamstring Syndrome: Care Instructions. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hamstring-syndrome-care-instructions.abr3618

Puranen, J., & Orava, S. (1988). The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American Journal of Sports Medicine, 16(5), 517–521. https://doi.org/10.1177/036354658801600515

Zion Physical Therapy. (2023). Hamstring Tendinitis Vs. Hamstring Syndrome. https://www.zionpt.com/post/hamstring-tendinitis-vs-hamstring-syndrome

Lower Limb Surgery. (2024). Hamstring Syndrome. https://www.lowerlimbsurgery.com/hamstring syndrome#:~:text=General%20Treatment%20Considerations,%E2%80%8B

April 3, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Physio acupuncture, chiropractic, Clinic, condition, contractions, cramps, decompression, dehydration, health, Injury, involuntary, leg, massage, medication, muscles, overexertion, pain, side effects

Leg Cramp Causes Explained: Your Guide

Can understanding how leg cramps feel, their causes, and prevention help individuals with treatment options?

Leg Cramp Causes

A leg cramp is an involuntary contraction of the muscles in the leg, typically the calf muscle. It causes a sudden, sharp, and painful tightening of the muscle. They commonly occur from

Dehydration
Muscle overexertion
They can be a symptom of an underlying health condition, such as type 2 diabetes or kidney failure.
They can also be a side effect of certain medications.

Sensation

Leg cramps typically cause sudden, severe pain in the affected muscle. Individuals may also feel a hard knot or twitching of the muscle. The calf muscles are the most common site. (Harvard Health Publishing, 2024)

Causes

The underlying cause of leg cramps isn’t always known. However, work, lifestyle factors, and medical conditions can play a role. Common causes include:

Muscle fatigue from overuse
Electrolyte imbalances (e.g., potassium, magnesium)
Dehydration
Poor circulation
Nerve damage
Certain medications (e.g., statins, diuretics)

Lifestyle Risk Factors

Certain lifestyle factors and other physical characteristics can increase the risk of leg cramps and can include: (Harvard Health Publishing, 2024) (National Library of Medicine, 2020)

Age (those 60 and over are affected more often than younger individuals)
Exercising in a hot environment
Exercising for extended periods
Obesity
Pregnancy

Medical Factors

Leg cramps are also associated with certain medical conditions and treatments for illness. Examples include: (Maughan R. J. & Shirreffs S. M. 2019) (Garrison, S. R. et al., 2020)

Pinched nerves in the lower back
Decreased blood circulation in the legs
Spinal cord injury
Certain medications (such as statins and diuretics)
Allergies
Gastrointestinal disease (digestive tract disorders)
Cardiovascular disease
Liver failure
Cancer
Dialysis – treatment to remove excess fluid from the blood when kidneys fail.
Respiratory diseases of the lungs and airways
Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a neurological condition affecting the brain, nerves, and muscles)

Self-Care

Leg cramps often go away on their own after a few minutes. However, other self-care can help. Recommendations: (Harvard Health Publishing, 2024)

Change Body Positions

Moving can help relieve tension and pain.
If the leg cramps happen at night, stand up and take a few steps.

Massage

Gently rubbing the cramped muscle can help it relax.

Stretch

Stretching the cramping muscle can help it relax.

Apply Heat

If the leg cramp lasts more than a few minutes, apply a heating pad or take a warm shower to increase blood circulation to and around the muscle to help it relax.

Treatment

There are no medications specifically for treating leg cramps. However, if symptoms are caused by another medical condition, treating the underlying condition might help reduce cramp frequency. Dehydration or low electrolytes can cause leg cramps; in these cases, drinking water or electrolyte-infused beverages can help. If cramps are related to overexercising, consider reducing the intensity of your activity or exercising in a cooler environment. (Maughan R. J. & Shirreffs S. M. 2019) Magnesium supplements are usually marketed to relieve muscle cramps; they are not proven to alleviate them. (Garrison, S. R. et al., 2020)

Exercises and Stretches

Knowing which muscle to target when stretching the leg is important. If the cramp does not resolve after the first stretch attempt, try again.

Hamstring Muscle

Pain in the back of the thigh. Here’s how to stretch the hamstrings (American Academy of Orthopaedic Surgeons, 2018)

Lie on your back.
Bend both knees and rest your feet on the ground or mattress if the cramp occurs at night.
On the leg that is cramping, bring the knee toward your chest.
Interlock the fingers behind your knee.
Slowly straighten the knee and pull your leg toward your head until you feel a stretching sensation along the back of the thigh.
Hold for 30 to 60 seconds.

Calf Muscle

The calf muscle is the most common for leg cramps. To stretch the calf muscle (American Academy of Orthopaedic Surgeons, 2018)

Stand facing a wall.
Place palms flat against the wall at shoulder height.
Step the cramping leg away from the wall around 12 to 18 inches.
Keep your heels flat on the floor.
Keeping the back leg straight, bend the front knee slowly and lean forward until you feel a stretch along the calf.
Hold for 30 to 60 seconds.

Prevention

They can’t always be prevented. However, if they are related to dehydration or other lifestyle factors, individuals may be able to prevent them from occurring or decrease the frequency. Try the following: (Harvard Health Publishing, 2024)

Drink plenty of water.
Stretch the leg muscles before you go to bed.
Try drinking a beverage with electrolytes for longer workouts or activities in hot weather.
Warm up before exercise, such as with a slow jog, before getting into more intense exercises.
Properly cool down after a workout.
Stretch the leg muscles before and after exercising.
Maintain a healthy body weight.

Contact a Healthcare Provider

Leg cramps can sometimes signify something more serious than a Charley horse. See a healthcare provider if any of the following symptoms present (National Library of Medicine, 2020)

Change in skin color, including redness or a deeper tone than normal
Cramps that last more than a few minutes or occur frequently
Muscle weakness
Severe pain from the cramps
Swelling
Warm skin

Injury Medical Chiropractic & Functional Medicine Clinic

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

Is Motion Key to Healing?

References

Harvard Health Publishing. (2024). How to get rid of muscle cramps in your legs. https://www.health.harvard.edu/pain/how-to-get-rid-of-muscle-cramps-in-your-legs

National Library of Medicine. (2020). Muscle cramps. Retrieved from https://medlineplus.gov/musclecramps.html

Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.), 49(Suppl 2), 115–124. https://doi.org/10.1007/s40279-019-01162-1

Garrison, S. R., Korownyk, C. S., Kolber, M. R., Allan, G. M., Musini, V. M., Sekhon, R. K., & Dugré, N. (2020). Magnesium for skeletal muscle cramps. The Cochrane database of systematic reviews, 9(9), CD009402. https://doi.org/10.1002/14651858.CD009402.pub3

American Academy of Orthopaedic Surgeons. (2018). Knee conditioning program. https://orthoinfo.aaos.org/en/recovery/knee-conditioning-program/

April 1, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care body, chiropractic, chiropractic care, dralexjimenez, graston, graston technique, gua, gua sha, health, muscle, muscle pain, musculoskeletal pain, nonsurgical, pain, scraping, sha, soft tissue, technique, wellness

Gua-Sha & Chiropractic Care for Wellness and Health: A Perfect Combo

Unlock the potential of gua-sha and chiropractic care. Learn how it can enhance your well-being and relieve tension.

Introduction: Rethinking Musculoskeletal Pain Through a Functional Medicine Lens

As a nurse practitioner with two decades of experience in physical and functional medicine, I’ve seen firsthand how musculoskeletal pain disrupts lives—whether it’s the desk-bound professional with chronic neck tension, the athlete recovering from overuse injuries, or the aging adult with persistent back discomfort. While pharmaceutical interventions may offer temporary relief, the key to long-term healing often lies in a more integrative approach.

Gua Sha therapy, a time-tested East Asian technique, combined with chiropractic care, offers a powerful, evidence-informed, and non-surgical strategy to alleviate musculoskeletal pain, restore function, and improve mobility. In this article, we’ll explore how these two modalities complement each other, the science behind their synergistic benefits, and how they can be integrated into a personalized treatment plan to support whole-body healing.

What Is Gua Sha Therapy? A Functional Medicine Perspective

Gua Sha (pronounced “gwah-shah”) is a traditional healing modality rooted in Traditional Chinese Medicine (TCM), involving the use of a smooth-edged instrument—often made of jade, rose quartz, or stainless steel—to gently scrape the skin in targeted areas. The goal? To release stagnation, promote microcirculation, and activate the body’s innate healing response.

The term “Gua” means “to scrape” and “Sha” refers to the reddish marks that appear on the skin, signifying the release of stagnant blood and toxins. These marks typically fade within a few days and are a normal part of the healing process.

In the modern clinical setting, Gua Sha has evolved into a sophisticated tool used by physical therapists, chiropractors, acupuncturists, and functional medicine providers. It’s particularly effective in addressing myofascial tension, trigger points, chronic inflammation, and reduced mobility due to soft tissue adhesions.

How Gua Sha Alleviates Musculoskeletal Pain

Musculoskeletal pain is often multifactorial—stemming from overuse, injury, postural imbalances, or systemic inflammation. When these factors are left unaddressed, they can lead to myofascial restrictions, scar tissue formation, and neuromuscular dysfunction, perpetuating a cycle of pain and immobility.

Gua Sha works by:

Disrupting fascial adhesions and encouraging tissue remodeling
Enhancing microvascular circulation, accelerating the delivery of oxygen and nutrients to the affected tissues
Activating the parasympathetic nervous system, shifting the body from “fight or flight” to “rest and repair”
Reducing pro-inflammatory cytokines and promoting anti-inflammatory responses (Chu et al., 2021)
Stimulating lymphatic flow, helping to reduce edema and clear metabolic waste
Releasing trigger points in hypertonic muscle groups, particularly in the neck, shoulders, lower back, and limbs

These mechanisms align well with the goals of functional medicine: identifying and treating root causes rather than masking symptoms.

Chiropractic Care: Aligning Structure and Function

Chiropractic care focuses on restoring proper spinal alignment and joint mobility through manual manipulation techniques. It is based on the principle that optimal nervous system function depends on structural integrity, particularly of the vertebral column.

Common benefits of chiropractic care include:

Pain reduction in the back, neck, and extremities
Improved range of motion and posture
Decompression of nerve roots, reducing radiculopathy and referred pain
Enhanced proprioception and neuromuscular coordination
Prevention of degenerative joint changes through biomechanical correction

A growing body of research supports chiropractic adjustments as an effective, evidence-based option for managing musculoskeletal conditions, especially when integrated into a multimodal treatment approach (Trager et al., 2024).

Discovering the Benefits of Chiropractic Care- Video

Gua Sha and Chiropractic Care: A Synergistic Duo

When Gua Sha is combined with chiropractic care, the result is a comprehensive therapeutic approach that targets both soft tissue restrictions and structural misalignments. This synergy accelerates healing and maximizes outcomes by preparing the body for more effective manual adjustments.

Here’s how the two modalities work together:

Gua Sha Therapy	Chiropractic Care
Breaks down adhesions in fascia and muscle tissue	Restores joint alignment and spinal biomechanics
Stimulates lymphatic and circulatory systems	Reduces nerve impingement and improves neural signaling
Releases tension in overactive muscle groups	Restores balance and mobility in underactive joints
Supports parasympathetic activation	Reinforces proprioceptive and neuromuscular patterns

One specific chiropractic application of Gua Sha is the Graston Technique, a modern adaptation that uses stainless steel instruments to identify and treat areas of soft tissue fibrosis. The goal is similar—restore mobility, reduce pain, and promote tissue healing (Deshmukh & Phansopkar, 2023).

Clinical Applications: When to Consider Gua Sha + Chiropractic Integration

As a nurse practitioner in functional medicine, I often incorporate both Gua Sha and chiropractic care for patients with:

Chronic neck pain and tension headaches
Myofascial pain syndrome (MPS)
Postural dysfunctions from prolonged desk work
Repetitive strain injuries (e.g., carpal tunnel, tennis elbow)
Lower back pain with fascial tightness
Post-surgical scar tissue and restricted mobility
TMJ dysfunction and facial tension
Sports-related injuries and performance recovery

These patients often report improved mobility, reduced inflammation, and greater pain relief when Gua Sha is included in their care plan—especially when timed before or after a chiropractic adjustment to reduce soft tissue guarding and enhance adjustment efficacy.

The Science: What Does the Research Say?

Numerous studies support the physiological effects of Gua Sha on circulation, inflammation, and pain modulation:

A 2021 study by Chu et al. found that Gua Sha therapy significantly increased microcirculation and decreased inflammatory markers in patients with chronic muscle pain.
Wang et al. (2020) highlighted Gua Sha’s role in stimulating the du meridian (governing vessel) and clearing blood stasis, promoting faster soft tissue recovery.
Knezevic et al. (2021) emphasized that musculoskeletal pain often arises from the interplay between soft tissue dysfunction, trigger points, and neural sensitization—areas where Gua Sha can provide targeted relief.
Trager et al. (2024) affirmed that chiropractic care continues to show promise as a cost-effective, non-pharmacological solution to chronic spinal pain and joint dysfunction.

Together, these therapies create a healing environment that supports the body’s biomechanical, neurological, and energetic systems.

Safety Considerations and Contraindications

While Gua Sha is a safe and gentle therapy, it is not suitable for everyone. Contraindications include:

Bleeding disorders or anticoagulant use
Severe varicose veins or vascular fragility
Active skin infections, open wounds, or dermatologic conditions
Recent surgeries with unhealed incisions

Always consult with a licensed provider trained in both modalities to determine appropriateness and ensure personalized, safe care.

Optimizing Results: A Functional Medicine Approach to Musculoskeletal Recovery

Incorporating Gua Sha and chiropractic care into a broader functional medicine care plan often yields the most sustainable results. Complementary strategies may include:

Anti-inflammatory nutrition
Targeted supplementation (e.g., magnesium, omega-3s, curcumin)
Postural training and ergonomic assessment
Myofascial release, cupping, or acupuncture
Stress management and sleep optimization

The body is a system of systems. Addressing musculoskeletal dysfunction holistically allows patients to heal not just their symptoms but the root cause of imbalance.

Conclusion: Empowering Patients With Integrative Pain Solutions

Musculoskeletal pain is one of the most common complaints in modern healthcare, yet the solution doesn’t have to be invasive, pharmaceutical, or surgical. By combining the ancient wisdom of Gua Sha with the mechanical precision of chiropractic care, we unlock a deeply therapeutic pathway toward healing, function, and resilience.

As a nurse practitioner grounded in both physical and functional medicine, I encourage patients and providers alike to explore the synergistic power of these modalities. When integrated skillfully and applied with intention, Gua Sha and chiropractic care can dramatically improve musculoskeletal health, restore balance, and empower patients to reclaim their active lives.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal pain by incorporating Gua-Sha and chiropractic care. When asking important questions to our associated medical providers, we advise patients to utilize Gua-Sha combined with chiropractic care to reduce musculoskeletal pain and restore soft tissue mobility in the extremities. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Chu, E. C., Lin, A. F. C., & Chu, V. (2023). The Inclusion of Chiropractic Care in the Healthy China Initiative 2030. Cureus, 15(8), e43068. https://doi.org/10.7759/cureus.43068

Chu, E. C. P., Wong, A. Y. L., Sim, P., & Kruger, F. (2021). Exploring scraping therapy: Contemporary views on ancient healing – A review. J Family Med Prim Care, 10(8), 2757-2762. https://doi.org/10.4103/jfmpc.jfmpc_360_21

Deshmukh, N. S., Jr., & Phansopkar, P. (2023). Effect of the Graston Technique and Cupping Therapy on Pain and Functions in Individuals With Medial Tibial Stress Syndrome: A Randomized Clinical Trial. Cureus, 15(11), e48246. https://doi.org/10.7759/cureus.48246

Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. The Lancet, 398(10294), 78-92. https://doi.org/10.1016/s0140-6736(21)00733-9

Trager, R. J., Bejarano, G., Perfecto, R. T., Blackwood, E. R., & Goertz, C. M. (2024). Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med, 13(19). https://doi.org/10.3390/jcm13195668

Wang, Y. W., Xi, Z. W., Pu, B., Chen, G. Y., Ma, Y. F., Liu, D. L., & Xu, X. (2020). Gua sha therapy for chronic low back pain: A protocol for systematic review. Medicine (Baltimore), 99(40), e20606. https://doi.org/10.1097/MD.0000000000020606

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April 1, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Therapy back, causes, chiropractic, Clinic, condition, disc, health, herniated, Injury, lower, muscle, pain, sciatica, spine, sprain, strain, various, walking, when

Back Pain When Walking: A Comprehensive Guide

For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?

Back Pain When Walking

Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.

Muscle Issues

Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)

Strains

Occur when the fibers in the back are overstretched or torn.
Pain from muscle strains is usually worse during activity and better when resting.

Sprains

It occurs when the ligaments that connect bone to bone become detached.
If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.

Fatigue

It can happen from overexertion and lead to lower back pain when walking.
It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.

Degenerative Disc Disease

Between each vertebra is a disc that provides cushioning between the bones.
As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)

Sciatica

Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)

Numbness
Tingling
Muscle cramps
Leg muscle weakness

Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.

Lumbar Spinal Stenosis

Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
It causes the space surrounding the spinal cord to narrow.
Sometimes, the narrowing can add pressure on the nerves, resulting in numbness, tingling, and weakness in the legs. (American Academy of Orthpaedic Surgeons, 2021)
Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.

Hyperlordosis

Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)

Prevention Strategies

Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)

Wear shoes made for walking.
Perform gentle lower back stretches before walking.
Start slowly by walking for a few minutes, then gradually increase the time.
Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
Warm up and cool down by walking slowly at the beginning and end of the walk.
This allows the back and leg muscles to warm up before exercise and recover afterward.
Walk at a slow to moderate pace/speed that allows one to converse.
Standing up straight while walking or standing upright reduces pressure on the lower back.

Alternative Exercise

If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)

Elliptical Trainer

This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.

Recumbent Biking

will keep the back upright, which is recommended if there is more pain when bending forward.

Upright Stationary Biking

This is recommended if the back pain improves when bending forward.

Walking In A Pool

This activity provides benefits while reducing pressure on the spine.
To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).

Water Aerobics

This activity provides cardiovascular health benefits with decreased pressure on the back.

Injury Medical Chiropractic & Functional Medicine Clinic

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

Beyond Adjustments: Chiropractic and Integrative Healthcare

References

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

Hospital for Special Surgery. (2024). Degenerative disc disease. https://www.hss.edu/condition-list_degenerative-disc-disease.asp

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

American Academy of Orthpaedic Surgeons. (2021). Lumbar spinal stenosis. https://orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/

American Academy of Orthopaedic Surgeons. (2020). Spine basics. https://orthoinfo.aaos.org/en/diseases–conditions/spine-basics/

Cedars-Sinai. (2025). Swayback (lordosis). https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html

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

Harvard Health Publishing. (2015). 5 tips for getting started with a walking program. https://www.health.harvard.edu/exercise-and-fitness/get-started

Hospital for Special Surgery. (2023). Best types of exercise for back pain. https://www.hss.edu/article_best-exercise-lower-back-pain.asp

March 29, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Athletes, Physio, Sporting chiropractic, Clinic, decompression, exercises, health, injuries, legs, massage, MET, nutritional, pain, physical, post-surgery, rehabilitation, relief, sports, strengthening, Therapy, wellness

Post Surgery Leg Strengthening Tips for Patients

What are some leg-strengthening exercises that will expedite recovery for athletes and physically active individuals who have undergone leg surgery?

Post Surgery Leg Strengthening

Leg muscles may weaken after hip, knee, ankle, or foot surgery. This happens because those muscles are not used as much during recovery. Gaining back strength and muscle endurance after an injury or surgery is an important step in recovery. Leg exercises can help regain mobility and prevent complications like blood clots and pressure sores after surgery or an injury, which is why engaging in post-surgery leg strengthening is important once the doctor gives the ok.

Benefits

post-surgery leg strengthening exercises have several benefits, including

Rebuilds strength and confidence
Retraining for optimal mobility and flexibility
Prevents pressure sores
Prevents blood clots

When the leg muscles are contracted, they move blood like a pump, maintaining proper circulation. Moving in a bed after surgery also helps prevent pressure sores from forming and blood clots. A physical therapy team will determine the right leg exercises for each individual and their injury/condition. This is an important step when moving forward after surgery. (Hoogeboom T. J. et al., 2014)

Starting Out

The first exercises should target all the major muscles of the leg. (Madara K. C. et al., 2019)

Gluteal Sets

This isometric exercise means the muscles contract while no motion occurs at the hip joints. To perform:

Lie on your back and tighten your buttock muscles.
Hold the muscles tight for 5 seconds, then relax.
Repeat 10 or 15 times.
Gluteal sets can be done several times per day.

Heel Slide

Heel slides can help regain strength in the major muscles of the leg. To perform:

Lie on your back.
Bend the knee of the surgical leg and slowly slide the heel toward your butt.
Slide as far as possible and hold for 5 seconds.
Slowly return to the starting position and repeat.

Short Arc Quad

The short arc quad, or SAQ, is a simple way to get the quadricep muscles working. To perform:

Lie on your back with a towel roll, small ball, or something similar under the knee.
Slowly straighten the knee.
Tighten the quad muscle on the top of the thigh.
Hold for 3 seconds, then relax.
Repeat 10 to 15 times.

Quad Set

This exercise helps get the quad muscles working. It also helps control the position of the kneecap. To perform:

Lie on your back.
Place a small towel roll under the knee.
Try to press the back of the knee flat against the floor.
Hold for 10 seconds and release.
Repeat 10 to 15 times.

Individuals can complete quad sets bilaterally or with both knees simultaneously. This makes the stronger leg help strengthen the weaker side.

Straight Leg Raise

To perform:

Lie on your back.
Lift your leg straight off the floor until it is at the height of the opposite bent knee.
Hold for 10 seconds and slowly lower.
Repeat 10 to 15 times.

Be sure to keep the knee straight for the entire exercise. Keep the opposite knee bent for comfort. To ensure the knee is straight, individuals can complete a quad set first and then the straight leg raise. The exercise can be more challenging by increasing repetitions or adding a 2- to 3-pound ankle weight on the thigh. For even more challenge, add the ankle weight to the ankle.

Hamstring Strengthening

Working out the hamstrings after injury or surgery is important. The hamstring muscles bend the knee and extend the hip backward. To perform:

Lie on your stomach.
Bend one knee to raise the lower limb straight in the air.
Hold for 5 seconds and lower slowly.
Repeat 10 to 15 times.

Once the exercise is easy to do, increase the repetitions to 30. Individuals can also try adding a 2- to 3-pound ankle weight.

Physical therapy can help individuals regain mobility after injury or surgery. A therapist may prescribe exercises as part of an at-home exercise program. Over time progress will go from simple exercises to more challenging ones to improve balance and mobility. (Madara K. C. et al., 2019)

Injury Medical Chiropractic & Functional Medicine Clinic

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

Are You Recovering From Ankle Sprains?

References

Hoogeboom, T. J., Dronkers, J. J., Hulzebos, E. H., & van Meeteren, N. L. (2014). Merits of exercise therapy before and after major surgery. Current opinion in anaesthesiology, 27(2), 161–166. https://doi.org/10.1097/ACO.0000000000000062

Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni, J., Jr., & Raisis, L. (2019). PROGRESSIVE REHABILITATION AFTER TOTAL HIP ARTHROPLASTY: A PILOT AND FEASIBILITY STUDY. International Journal of Sports Physical Therapy, 14(4), 564–581.

Tag: pain

Introduction

Introduction: A Holistic Approach to Health and Healing

The Role of Chiropractic Care in Optimal Health

The Nurse Practitioner’s Role: Comprehensive Medical Management

Synergistic Benefits of Dual Licensure

1. Comprehensive Assessment and Diagnosis

2. Interdisciplinary Treatment Options

3. Targeted Management of Histamine Intolerance

4. Enhanced Pain and Inflammation Management

5. Personalized, Preventive Care

Fighting Inflammation Naturally-Video

Case Study: Managing Histamine Intolerance Holistically

Conclusion: Empowering Health Through Integration

Injury Medical & Functional Medicine Clinic

References

Disclaimer

Introduction

The Link Between Neck Pain and Migraines: Cervicogenic and Neurovascular Overlap

The Cervical Trigeminovascular Connection

Common Migraine-Associated Neck Pain Triggers

Fibromyalgia: An Amplifier of Migraines and Neck Pain

Tension Headaches Explained- Video

Holistic and Functional Interventions for Migraine Management

1. Chiropractic Care and Manual Therapy: Restoring Cervical Balance

Key Chiropractic Techniques:

2. Postural Retraining and Ergonomics: Reducing Structural Strain

Postural Interventions:

3. Anti-Inflammatory Nutrition: Healing from Within

Functional Nutrition Recommendations:

Integrated Care Planning: The Functional Medicine Model

A Sample Care Plan May Include:

Empowering Patients Through Education and Collaboration

Conclusion: Migraines and Neck Pain—An Opportunity for Functional Healing

Injury Medical & Functional Medicine Clinic

References

Disclaimer

Supine Position

Medical Uses

Examinations

Procedures

Surgery

Overall Health

Natural Position

Back Pain Relief

Acid Reflux

Sleep Apnea

Clinical Uses

Back Care

Variations

Lawn Chair Position

Frog-Leg Position

Injury Medical Chiropractic & Functional Medicine Clinic

Thoracic Spine Pain

References

Throwing a Ball and Shoulder Pain

Throwing Motion

Causes of Pain

Symptoms

Aching Pain

Dead Arm

Pain at Night

Diagnosis

Treatment

Physical Therapy

Injury Medical Chiropractic and Functional Medicine Clinic

Lumbar Spine Injuries in Sports: Chiropractic Healing

References

Introduction

Understanding Musculoskeletal Disorders: A Functional Medicine Perspective

Why Non-Surgical Interventions Matter

Calisthenics: The Foundation of Functional Movement

What Is Calisthenics?

Calisthenics and Health Optimization

Can Core Exercises Help With Back Pain?-Video

Chiropractic Care: Restoring Biomechanical Integrity

What Does Chiropractic Care Do?

The Synergy Between Calisthenics and Chiropractic Care

Key Integration Strategies:

Evidence-Based Calisthenics for Musculoskeletal Pain