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By admin 0 Comments Chiropractic Care, Exercises , , , , , , , , , , , , , , , , , ,

The Benefits of Standing Lower Back Flexion for Pain Management

Could incorporating standing lumbar flexion exercise into a daily routine help decrease pain and improve overall spinal mobility for individuals with low back pain?

Standing Lower Back Flexion Exercise

A chiropractic physical therapy team visit can help determine which exercises are best for an individual’s injury or condition and teach them what to stop doing if they have low back pain. Exercise and proper posture can decrease discomfort and improve mobility for individuals with low back pain. (Suh, J. H. et al., 2019) Sometimes, exercises that bend backward are recommended, while other times, flexion or forward bending movements are the best way to manage lower back pain. Many find the standing Williams lumbar flexion exercises maneuver helpful for low back pain. (Amila A, Syapitri H, Sembiring E. 2021)

Benefits

Individuals with certain diagnoses may benefit from spinal flexion. These diagnoses include:

Be sure to speak with a healthcare provider to understand the diagnosis and low back symptoms, and work with a physical therapist to be sure that forward flexion of the spine is the correct exercise for your back.

When To Avoid Lumbar Flexion

Some should avoid excessive forward bending, which could cause further damage or injury to the spine. Reasons to avoid flexion include:

Before starting this or any other exercise program for your spine, check with a healthcare provider or physical therapist.

How to Perform

Gradually progressing with other gentle lumbar flexion exercises before full-standing lumbar flexion is recommended. These include performing a week or two of lumbar flexion lying down, followed by a couple weeks of lumbar flexion seated. Once these exercises are easy to perform and pain-free, progress with lumbar flexion standing postures.​To perform, follow these steps:

  • Stand with your feet shoulder-width apart.
  • Slowly bend forward by sliding your hands down the front of your thighs.
  • Reach down as far as possible and let your lower back bend forward.
  • Grab your ankles and gently pull into more forward flexion to increase the backstretch.
  • Hold the end position for a second or two, then slowly return to the starting position.

As you exercise, be sure to monitor changes in symptoms. Pain worsening in the back or traveling down your leg indicates that you should stop the exercise (Spine-health, 2017). If the pain decreases in your leg or centralizes to your back, continue the exercise. Standing lumbar flexion can be repeated for 10 repetitions a couple of times daily. It can help decrease low back or leg pain symptoms and stretch tight hamstrings and back muscles. (Montefiore Pediatric Orthopedic and Scoliosis Center, 2003)

Injury Medical Chiropractic and Functional Medicine Clinic

Exercise can also prevent future lower back problems. Standing back flexion, postural correction, regular physical activity, and exercise are tools for keeping the spine healthy. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

What Causes Disc Herniation?

References

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

Amila A, Syapitri H, Sembiring E. (2021). The effect of William Flexion Exercise on reducing pain intensity for elderly with low back pain. Int J Nurs Health Serv., 4(1), 28-36. https://doi.org/https://doi.org/10.35654/ijnhs.v4i1.374

Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. https://doi.org/10.1136/bmj.h6234

Sfeir, J. G., Drake, M. T., Sonawane, V. J., & Sinaki, M. (2018). Vertebral compression fractures associated with yoga: a case series. European journal of physical and rehabilitation medicine, 54(6), 947–951. https://doi.org/10.23736/S1973-9087.18.05034-7

Howell E. R. (2012). Conservative management of a 31 year old male with left sided low back and leg pain: a case report. The Journal of the Canadian Chiropractic Association, 56(3), 225–232.

Spine-health. (2017). Exercise with lower back pain: Should you work through the pain? Spine-health
Knowledge from Veritas. https://www.spine-health.com/blog/exercising-lower-back-pain-should-you-work-through-pain

Montefiore Pediatric Orthopedic and Scoliosis Center. Center, M. P. O. a. S. (2003). Low Back Strain. https://www.cham.org/File%20Library/Global%20Navigation/Expertise%20And%20Programs/Pediatric%20Expertise/Orthopedics/Monte-LOW-BACK-STRAIN-WITH-EXERCISES.pdf

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Sparkling Water and Weight Loss: Does It Really Work?

Can individuals add sparkling water to their diet to help lower blood sugar and aid with weight loss?

Sparkling Water

Sparkling water is generally considered a healthy drink with health benefits. It is refreshing, increases hydration, improves digestion, and may even help with weight loss (Takahashi A. 2025) (University of Chicago Medicine, 2023). This is nothing new. A previous study suggested that carbonated water makes the body feel full. The carbonation in sparkling water can trick the stomach into feeling fuller, potentially reducing overall calorie intake by curbing snacking between meals, which could prevent overeating and weight gain. (Wakisaka S. et al., 2012) However, a new report suggests carbonated water may help with weight loss by enhancing glucose/sugar uptake and metabolism. (Takahashi A. 2025) But further research is needed.

Lower Blood Sugar Levels

The report compared the effects of carbonated water to hemodialysis, a treatment that filters blood for individuals with kidney failure. (Takahashi A. 2025) Hemodialysis turns the blood alkaline, enhancing glucose absorption and metabolism. (EurekAlert, 2025)

Researchers assume that the carbon dioxide (CO2) absorbed after drinking sparkling water and the CO2 supplied during hemodialysis behave similarly. Carbonated water may consume glucose in the blood near the stomach, temporarily lowering blood sugar levels. However, the researchers suggested that follow-up continuous glucose monitoring (CGM) studies to measure blood sugar levels before and after drinking carbonated water would be necessary to validate the effect.

This does not mean that after drinking sparkling water, there will be major changes to an individual’s weight. Something metabolically is probably happening, but it’s still barely being discovered. The impact of CO2 in carbonated water is not a standalone solution for weight loss. (Takahashi A. 2025)

Adding To A Diet

If sparkling water can help manage blood glucose, it could also affect how the body stores fat. Over time, high blood sugar levels can overwhelm the body, and excess sugar becomes stored as body fat instead of being stored properly for energy use, causing weight gain. (Centers for Disease Control and Prevention, 2024) But for the most part, according to the research, the carbon dioxide in sparkling water may help to prevent this by stimulating glycolysis, or the process the body uses to break down glucose for energy and keep blood sugar levels low. (National Cancer Institute, N.D) (Takahashi A. 2025) Further research is needed to confirm and understand how sparkling water can proficiently and effectively work for weight loss.

Carbonated water alone is unlikely to contribute to significant weight loss. However, sparkling water can be a useful tool for weight loss as part of a healthy lifestyle (Takahashi A. 2025). A balanced diet and regular exercise are still essential for effective weight management.

Weight Gain

Some researchers have questioned whether sparkling water can lead to weight gain. A study on rats and humans found a link between drinking carbonated water and increased levels of the hunger-stimulating hormone ghrelin. (Eweis D. S., Abed F., & Stiban J. 2017) This could lead to increased appetite and higher calorie consumption, but more research is needed, as sleep, physical activity levels and hydration also impact hormones.

Individuals interested in including carbonated water in a balanced diet should check the labels for the caloric content, added sugars, and sugar alcohols, like xylitol or erythritol, which can cause gas or bloating. It is ideal if the label says water and carbonation; the fewer ingredients, the better.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Chiropractic Care and Metabolism: The Hidden Link

References

Takahashi A. (2025). Can carbonated water support weight loss? BMJ Nutr Prev Health. https://doi.org/10.1136/bmjnph-2024-001108

University of Chicago Medicine. (2023). Is sparkling water good for you? What about hard seltzer? https://www.uchicagomedicine.org/forefront/health-and-wellness-articles/is-carbonated-water-good-for-you

Wakisaka, S., Nagai, H., Mura, E., Matsumoto, T., Moritani, T., & Nagai, N. (2012). The effects of carbonated water upon gastric and cardiac activities and fullness in healthy young women. Journal of nutritional science and vitaminology, 58(5), 333–338. https://doi.org/10.3177/jnsv.58.333

EurekAlert. (2025). Fizzy water might aid weight loss by boosting glucose uptake and metabolism. BMJ Nutrition Prevention & Health. https://doi.org/10.1136/bmjnph-2024-001108

Centers for Disease Control and Prevention. (2024). About insulin resistance and type 2 diabetes. Retrieved from https://www.cdc.gov/diabetes/about/insulin-resistance-type-2-diabetes.html

National Cancer Institute. (N.D.). Glycolysis. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/glycolysis

Eweis, D. S., Abed, F., & Stiban, J. (2017). Carbon dioxide in carbonated beverages induces ghrelin release and increased food consumption in male rats: Implications on the onset of obesity. Obesity research & clinical practice, 11(5), 534–543. https://doi.org/10.1016/j.orcp.2017.02.001

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Harnessing the Power of the Coconut: Discover its Beneficial Properties

Can coconut be a healthier alternative food option for individuals trying to improve their health and wellness?

The Coconut

Located in the tropical regions around the world, especially in Southeast Asia, the Pacific islands, sunny coastal states in the U.S., and India, the coconut (Cocos nucifera L.) is a monoecious perennial palm that has many uses for people who are looking for alternatives in their dietary needs. Known as the “tree of life,” the coconut has numerous utilities that people can incorporate from food, medicine, and household products. (Beveridge et al., 2022) The outer coconut husk is used in household items, while the coconut fruit is used for food and medicinal purposes, from antibacterial and antioxidant to containing microminerals and nutrients. (DebMandal & Mandal, 2011) This tropical fruit can be used in baked goods, skin products, and food dishes and can help restore the body’s electrolytes. We associate with certified medical providers who inform our patients of the importance of incorporating healthy foods like coconut into a healthy diet. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily dietary intake to feel good. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Nutritional Facts

With coconut being a versatile fruit, it has many nutritional benefits. It is classified as a medium-chaired saturated fat absorbed by the body differently and can help reduce LDL-Cs (low-density lipoproteins, reduce cardiovascular diseases, and improve cognitive function. (Hewlings, 2020) When it comes to the nutritional facts of eating one piece of coconut is about:

  • 1 piece of coconut: 45g
  • Calories: 159
  • Total Fats: 15g
    • Saturated fat: 13g
  • Cholesterol: 0mg
  • Sodium: 9mg
  • Potassium: 160mg
  • Total Carbohydrate: 7g
    • Dietary fibers: 4.1
    • Sugar: 2.8g
  • Protein: 1.5g

Coconuts are high in saturated fats and medium-chain fatty, so they can cross the blood-brain barrier and be absorbed, transported, and utilized for energy production for the body. They can also provide beneficial properties to the gut microbiome. (Fan et al., 2022) At the same time, if people drink the water from the coconut, its nutritional facts include:

  • 1 cup of coconut water: 240g
  • Calories: 45
  • Total Fats: 0.5g
    • Saturated fat: 0.4g
  • Cholesterol: 0mg
  • Sodium: 252mg
  • Potassium: 600mg
  • Total Carbohydrate: 9g
    • Dietary fiber: 2.6g
    • Sugar: 6g
  • Protein: 1.7g

Food As Medicine- Video

The Health Benefits Of The Coconut

With the coconut tree being “the tree of life,” the fruit has many beneficial properties for health and wellness. For instance, using coconut oil for cooking has many advantages, such as being resistant to oxidation and polymerization due to its high saturated fatty acid content, being consumed at low levels, and reducing cardiovascular diseases. (Schwingshackl & Schlesinger, 2023) At the same time, when people start to use coconut oil for part of their cooking, they will notice that their body weight decreases. (Duarte et al., 2022). Below are other beneficial properties when people start incorporating coconut into their diet.

Replenish Electrolytes

Many people starting to work out or are physically active can utilize coconut water to replace sports drinks to replenish their electrolytes. When a person is exercising and sweating profusely, water and sodium levels are depleted, thus compromising the cardiovascular system’s ability to maintain a person’s exercise performance. (O’Brien et al., 2023) Hence, drinking coconut water can help rehydrate the body and replenish those electrolytes. At the same time, incorporating a bit of citrus fruit can provide extra health benefits and enhance the flavor of coconut water.

Reduces Blood Sugar

Coconuts can also help lower blood sugar levels, and for diabetic individuals, it can help reduce their blood glucose to healthy levels, regulate their carbohydrate metabolism, and improve their antioxidant capacity to reduce any comorbidities associated with diabetes. (Dai et al., 2021) Additionally, many diabetic individuals can substitute regular sugar with coconut sugar as it has a high nutritional value and a low glycemic index that can be beneficial to moderate glucose absorption. (Saraiva et al., 2023)

Adding Coconut To Your Diet

Many people can incorporate coconut into their diet by eating the fruit, drinking the coconut water, and utilizing it for smoothies and baked goods. By adding coconut to a healthy diet, many people can get their healthy fats in moderation, their electrolytes replenished, and enjoy eating clean, healthy foods. Making small changes by incorporating foods that have antioxidants into a healthy diet can help many people eat healthier and have more energy. At the same time, when people incorporate physical activity with their diet, they will begin to notice small positive changes in themselves and their bodies, thus leading happy, healthier lives.

References

Beveridge, F. C., Kalaipandian, S., Yang, C., & Adkins, S. W. (2022). Fruit Biology of Coconut (Cocos nucifera L.). Plants (Basel), 11(23). https://doi.org/10.3390/plants11233293

Dai, Y., Peng, L., Zhang, X., Wu, Q., Yao, J., Xing, Q., Zheng, Y., Huang, X., Chen, S., & Xie, Q. (2021). Effects of coconut water on blood sugar and retina of rats with diabetes. PeerJ, 9, e10667. https://doi.org/10.7717/peerj.10667

DebMandal, M., & Mandal, S. (2011). Coconut (Cocos nucifera L.: Arecaceae): in health promotion and disease prevention. Asian Pac J Trop Med, 4(3), 241-247. https://doi.org/10.1016/S1995-7645(11)60078-3

Duarte, A. C., Spiazzi, B. F., Zingano, C. P., Merello, E. N., Wayerbacher, L. F., Teixeira, P. P., Farenzena, L. P., de Araujo, C., Amazarray, C. R., Colpani, V., & Gerchman, F. (2022). The effects of coconut oil on the cardiometabolic profile: a systematic review and meta-analysis of randomized clinical trials. Lipids Health Dis, 21(1), 83. https://doi.org/10.1186/s12944-022-01685-z

Fan, L., Zhu, X., Sun, S., Yu, C., Huang, X., Ness, R., Dugan, L. L., Shu, L., Seidner, D. L., Murff, H. J., Fodor, A. A., Azcarate-Peril, M. A., Shrubsole, M. J., & Dai, Q. (2022). Ca:Mg ratio, medium-chain fatty acids, and the gut microbiome. Clin Nutr, 41(11), 2490-2499. https://doi.org/10.1016/j.clnu.2022.08.031

Hewlings, S. (2020). Coconuts and Health: Different Chain Lengths of Saturated Fats Require Different Consideration. J Cardiovasc Dev Dis, 7(4). https://doi.org/10.3390/jcdd7040059

O’Brien, B. J., Bell, L. R., Hennessy, D., Denham, J., & Paton, C. D. (2023). Coconut Water: A Sports Drink Alternative? Sports (Basel), 11(9). https://doi.org/10.3390/sports11090183

Saraiva, A., Carrascosa, C., Ramos, F., Raheem, D., Lopes, M., & Raposo, A. (2023). Coconut Sugar: Chemical Analysis and Nutritional Profile; Health Impacts; Safety and Quality Control; Food Industry Applications. Int J Environ Res Public Health, 20(4). https://doi.org/10.3390/ijerph20043671

Schwingshackl, L., & Schlesinger, S. (2023). Coconut Oil and Cardiovascular Disease Risk. Curr Atheroscler Rep, 25(5), 231-236. https://doi.org/10.1007/s11883-023-01098-y

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A Closer Look at the Different Stages of Frozen Shoulder

For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain?

Frozen Shoulder Stages

A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing.

Stage 1

Pre-Freezing – 1 month to 3 months

Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017)

Root Cause

A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren’t known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025)

Stage 2

Freezing – 10 weeks to 8 months

The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024)

Stage 3

Frozen – 4 months to 12 months

The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult.

Stage 4

Thawing – 5 months to 2 years

In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint’s mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable.

Treatment

Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019)

Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017)

Prognosis

The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Motion Key To Healing

References

Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. https://doi.org/10.1067/j.cpradiol.2024.03.005

Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. https://doi.org/10.11622/smedj.2017107

Johns Hopkins Medicine. (2025). Frozen shoulder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder

UpToDate. (2024). Patient education: Frozen shoulder (beyond the basics). https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. https://doi.org/10.5435/JAAOS-D-17-00606

Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. https://doi.org/10.1177/1758573216676786

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Smart Snacking: Enhance Your Workout with Nutritional Snacks

Can individuals incorporate nutritional snacks to consume before and after to have an effective workout and abundant energy?

How Can Exercise Help The Body?

When many people start thinking about their health and how to improve it, they usually begin exercising and eating healthier around the last week before the new year to jumpstart their health and wellness journey. These small changes can help the body tremendously as environmental factors like stress, physical inactivity, and various lifestyles can negatively impact the body, thus leading to stress and environmental factors. For individuals dealing with musculoskeletal disorders or autoimmune disorders, exercises and a healthy diet filled with nutritional foods can help mitigate pain-like symptoms and overlapping risk profiles. For individuals with low back pain, core stabilization exercises can help reduce pain and disability while improving core muscle activation to strengthen weak muscles. (Nayyab et al., 2021) As a non-surgical therapy, everyone can exercise for the body, which can help many people reduce any chronic diseases and issues they are dealing with. (Vina et al., 2012) At the same time, a person can exercise at any fitness level by incorporating the right amount of healthy snacks before and after a good workout. We associate with certified medical providers who inform our patients of the importance of having healthy snacks before and after working out to replenish the body and have energy throughout the day. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to restore energy through healthy snacking. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Secrets of Optimal Wellness- Video

Pre- & Post Workout Benefits

When starting to work out, it is important to ensure that the body is properly fueled with the proper carbohydrates, proteins, and healthy fats that can be converted into energy to perform any exercise routines at full capacity. For athletic individuals, nutrition is closely connected with physical activity and the timing of when the body uses that energy. (Januszko & Lange, 2021) Hence, it is important for individuals starting to work out to consume enough energy through nutritional foods in a pre-workout environment.  Pre-workout supplementation can help significantly improve greater changes in body composition and strength. (Cabre et al., 2022) Pre-workouts have benefited from increasing energy, enhancing strength and endurance, and reducing muscle fatigue through supplementation and healthy snacks that give people energy. Post-workouts can help with muscle recovery, and post-workout snacks can help maintain the body’s energy levels throughout the day.

Pre-Workout Snacks

Many dietary supplements for pre-workouts can help with health and performance improvement as they help increase muscle mass and strength while providing energy when exercising. (Brisebois et al., 2022) At the same time, incorporating carbohydrates can provide glycogen energy stored in the liver to provide muscle energy. (Henselmans et al., 2022) It is important to note that eating an hour before working out can give beneficial results. Some of the snacks many people can make and eat before working out include:

  • Chocolate milk with banana
  • Frozen grapes
  • Granola bar
  • Pretzels

Post Workout Snacks

It is important to restore and maintain that energy in the body when it comes to post-workout snacks after an intense workout. Many athletic and non-athletic individuals can incorporate nutritional carbohydrates and proteins to improve their physiological and biochemical adaptations to promote faster recovery and maintain the body’s hydration status. (Baroni et al., 2023) For instance, coconut water can be an alternative to sports drinks to replenish the body’s electrolytes. (O’Brien et al., 2023) Some of the post-workout snacks that are packed with protein and healthy carbs include:

  • Smoothies made with fruits, Greek yogurt, and protein powders
  • Chocolate milk with almonds
  • Crackers with string cheese
  • Cottage cheese

References

Baroni, L., Pelosi, E., Giampieri, F., & Battino, M. (2023). The VegPlate for Sports: A Plant-Based Food Guide for Athletes. Nutrients, 15(7). https://doi.org/10.3390/nu15071746

Brisebois, M., Kramer, S., Lindsay, K. G., Wu, C. T., & Kamla, J. (2022). Dietary practices and supplement use among CrossFit(R) participants. J Int Soc Sports Nutr, 19(1), 316-335. https://doi.org/10.1080/15502783.2022.2086016

Cabre, H. E., Gordon, A. N., Patterson, N. D., & Smith-Ryan, A. E. (2022). Evaluation of pre-workout and recovery formulations on body composition and performance after a 6-week high-intensity training program. Front Nutr, 9, 1016310. https://doi.org/10.3389/fnut.2022.1016310

Henselmans, M., Bjornsen, T., Hedderman, R., & Varvik, F. T. (2022). The Effect of Carbohydrate Intake on Strength and Resistance Training Performance: A Systematic Review. Nutrients, 14(4). https://doi.org/10.3390/nu14040856

Januszko, P., & Lange, E. (2021). Nutrition, supplementation and weight reduction in combat sports: a review. AIMS Public Health, 8(3), 485-498. https://doi.org/10.3934/publichealth.2021038

Nayyab, I., Ghous, M., Shakil Ur Rehman, S., & Yaqoob, I. (2021). The effects of an exercise programme for core muscle strengthening in patients with low back pain after Caesarian-section: A single blind randomized controlled trial. J Pak Med Assoc, 71(5), 1319-1325. https://doi.org/10.47391/JPMA.596

O’Brien, B. J., Bell, L. R., Hennessy, D., Denham, J., & Paton, C. D. (2023). Coconut Water: A Sports Drink Alternative? Sports (Basel), 11(9). https://doi.org/10.3390/sports11090183

Vina, J., Sanchis-Gomar, F., Martinez-Bello, V., & Gomez-Cabrera, M. C. (2012). Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol, 167(1), 1-12. https://doi.org/10.1111/j.1476-5381.2012.01970.x

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Managing Myofascial Pain Syndrome: Breaking the Spasm Cycle

For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles?

Myofascial Pain Syndrome Spasm Cycles

Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa.

Spasm Pain Cycle

Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021)

Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014)

Trigger Points

  • Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.

Muscle Tension

  • A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.

Pain-Spasm-Pain Cycle

  • The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.

How Spasms and Pain Present

Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014)

Causes

Repetitive Motions

  • Repeating the same movement, like typing on a computer, can trigger muscle tension and points.

Poor Posture

  • Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.

Muscle Injury

  • Past injuries can leave muscles susceptible to developing trigger points and pain cycles.

Stress

  • Psychological stress can lead to muscle tension and exacerbate existing trigger points.

Break the Cycle

Physical Therapy

  • A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.

Exercise

  • Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.

Heat Therapy

  • Applying heat to affected areas can help relax muscles and alleviate pain.

Ergonomics

  • Modifying work habits and posture to reduce strain on muscles.

Stress Management

  • Techniques like deep breathing and meditation can help reduce stress-related muscle tension.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Personal Injury Rehabilitation

References

Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. https://doi.org/10.1155/2014/523924

Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. https://doi.org/10.1016/j.jcm.2016.08.010

Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. https://doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5

THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. https://www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. https://doi.org/10.1016/j.pmrj.2015.01.024

Cleveland Clinic. (2023). Chronic myofascial pain (CMP). https://my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome

Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. https://doi.org/10.1589/jpts.27.3283

Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. https://doi.org/10.1007/s11916-012-0289-4

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Relief from Thigh Pain Associated with Sciatica: Proven Methods

Can individuals dealing with sciatica incorporate nonsurgical treatments to reduce thigh pain and restore mobility in the legs and hips?

The Tensor Fascia Latae

Do you feel stiffness or tightness in your legs, feet, and hips? Have you experienced walking crookedly when running errands? Or have you experienced radiating pain from your gluteal region down to your feet? The hips, thighs, and legs have numerous muscles, tissues, and ligaments surrounding the skeletal bone in the body’s lower extremities. These components allow the lower half of the body to stabilize the upper body’s weight and enable the individual to be mobile throughout the day. One muscle that works together is the tensor fasciae latae (TFL) muscle. The TFL muscle is part of the proximal anterolateral thigh between the deep fibers of the iliotibial (IT) band. It works with the gluteal muscles in various hip movements and assists with the knees. (Trammell et al., 2025) This muscle is poorly misunderstood as it helps with the hips and knee joint and pelvic stability. (Iyengar et al., 2022) At the same time, it has a casual relationship with the IT band.

The Iliotibial Band (ITB)

The iliotibial (IT) band is part of the lower extremities as it is a tough, fibrous fascial tissue that works together with the TFL muscle and has various functional roles that are dependent on posture and allows the individual to be mobile via walking, sprinting, and running. (Hutchinson et al., 2022) However, this muscle’s main function is knee flexion. When environmental factors affect the body, it can cause irritation and inflammation to the IT band, causing knee pain. (Martinez-Velez et al., 2020) When dealing with issues within their lower extremities, they affect the IT band, TFL muscle, and the thighs. Environmental factors can also affect the lower extremities as the surrounding muscles can aggravate the nerve roots, thus leading to sciatica pain. We associate with certified medical providers who inform our patients of how sciatica can negatively impact the lower extremities, especially the thighs. While asking important questions to our associated medical providers, we advise patients to integrate various non-invasive treatments to reduce sciatica and help regain mobility back to the lower body. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Reclaim Your Mobility: Chiropractic Care For Sciatica Recovery-Video

Sciatica & Thigh Pain

When the general population hears about sciatica, it is a frequent diagnosis associated with low back pain, which causes discomfort within the lower extremities, especially in the thighs. Sciatica is a debilitating condition where the sciatic nerve is often compressed and irritated, causing pain. (Davis et al., 2025) Many influences cause sciatica to develop, and it can cause the individual to deal with a spinal imbalance, which correlates with walking incorrectly, causing the accessory muscles to work overtime and compressing the sciatic nerve, causing thigh pain. (Wang et al., 2022) With thigh pain correlating with sciatica, many symptoms can range from muscle weakness, absence of tendon reflexes to the knees, and sensory deficit. (Fairag et al., 2022) Luckily, treatments are available to reduce thigh pain associated with sciatica and regain mobility back to the lower extremities.

Treatments For Sciatica-Thigh Pain

When treating the lower extremities, especially when experiencing sciatica-thigh pain, many individuals with thigh pain associated with sciatica can incorporate non-invasive treatments to reduce the pain. Many athletic and non-athletic individuals can utilize PRICE (protection, rest, ice, compression, and elevation) to the affected muscles that can minimize the injuries causing pain. (Lempainen et al., 2022) This can help reduce the inflammatory effects causing issues to the thighs and lower extremities. Many non-surgical treatments like physio-exercise therapy, massages, stretching, and spinal stabilization therapies can improve core strength and posture and help with range of motion to relieve sciatica pain affecting the lower extremities. (Aguilar-Shea et al., 2022) Other non-surgical treatments like yoga, physical therapy, and chiropractic care can help improve joint and lower extremity motions, stretch and strengthen weak muscles surrounding the thighs, and relieve sciatic nerve pain. (Kim & Yim, 2020) When people start thinking about their bodies and how pain is affecting their quality of life, many can incorporate non-surgical treatments to reduce the pain associated with sciatica. Many people can make small positive changes in their routine by becoming more physically active, stretching more, eating healthier, and being more mindful of what they are doing, which can reduce the chances of sciatica returning and affecting the lower extremities. This can help them achieve a healthier, better life.

References

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-Gonzalez, R., & Paredes, I. (2022). Sciatica. Management for family physicians. J Family Med Prim Care, 11(8), 4174-4179. https://doi.org/10.4103/jfmpc.jfmpc_1061_21

Davis, D., Maini, K., Taqi, M., & Vasudevan, A. (2025). Sciatica. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939685

Fairag, M., Kurdi, R., Alkathiry, A., Alghamdi, N., Alshehri, R., Alturkistany, F. O., Almutairi, A., Mansory, M., Alhamed, M., Alzahrani, A., & Alhazmi, A. (2022). Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated Overview. Cureus, 14(11), e31405. https://doi.org/10.7759/cureus.31405

Hutchinson, L. A., Lichtwark, G. A., Willy, R. W., & Kelly, L. A. (2022). The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med, 52(5), 995-1008. https://doi.org/10.1007/s40279-021-01634-3

Iyengar, K. P., Azzopardi, C., Kiernan, G., & Botchu, R. (2022). Isolated pathologies of Tensor Fasciae Latae: Retrospective cohort analysis from a tertiary referral centre. J Clin Orthop Trauma, 29, 101870. https://doi.org/10.1016/j.jcot.2022.101870

Kim, B., & Yim, J. (2020). Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J Exp Med, 251(3), 193-206. https://doi.org/10.1620/tjem.251.193

Lempainen, L., Mecho, S., Valle, X., Mazzoni, S., Villalon, J., Freschi, M., Stefanini, L., Garcia-Romero-Perez, A., Burova, M., Pleshkov, P., Pruna, R., Pasta, G., & Kosola, J. (2022). Management of anterior thigh injuries in soccer players: practical guide. BMC Sports Sci Med Rehabil, 14(1), 41. https://doi.org/10.1186/s13102-022-00428-y

Martinez-Velez, A., Suwan, P., & Dua, A. (2020). Iliotibial band syndrome in non-athletes. Minerva Anestesiol, 86(10), 1111-1112. https://doi.org/10.23736/S0375-9393.20.14194-4

Trammell, A. P., Nahian, A., & Pilson, H. (2025). Anatomy, Bony Pelvis and Lower Limb: Tensor Fasciae Latae Muscle. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29763045

Wang, L., Li, C., Wang, L., Qi, L., & Liu, X. (2022). Sciatica-Related Spinal Imbalance in Lumbar Disc Herniation Patients: Radiological Characteristics and Recovery Following Endoscopic Discectomy. J Pain Res, 15, 13-22. https://doi.org/10.2147/JPR.S341317

Disclaimer

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Mustard: A Low-Calorie Alternative Packed with Health Benefits

Can mustard be a low-calorie alternative to higher-fat condiments for individuals trying to reduce calorie intake?

Mustard

Prepared mustard is a common condiment used around the country. It is a low-calorie, highly flavored condiment that can replace more calorie-dense options. The familiar condiment combines mustard seeds with vinegar, salt, lemon, and other ingredients. There are also different varieties made from brown or black mustard seeds.

Health Benefits

Mustard is considered healthy because it contains antioxidants that provide various health benefits, including anti-cancer, antibacterial, antiviral, antifungal, anti-inflammatory, and wound-healing properties. (Mazumder A., Dwivedi A., & du Plessis J. 2016) Although not associated with significant health benefits, mustard is a low-calorie alternative to many higher-fat condiments, like mayonnaise. Different types of mustard seeds are used for health purposes. For example, some herbalists use white mustard seeds to clear the throat when mixed with honey (Ewing, Sarah, 1999). Antioxidants include isothiocyanates and sinigrin.

  • Isothiocyanates, the oil that gives mustard its pungent taste, have anti-cancer properties for breast, lung, GI tract, and prostate cancers.
  • However, the mechanism remains unclear, and more research is needed to determine the efficacy of mustard’s health benefits for cancer.
  • Isothiocyanates may also help manage diabetes and reduce unhealthy cholesterol, providing cardiovascular protection and neurological benefits that may help autistic individuals. More research is needed. (Palliyaguru D. et al., 2018)
  • Sinigrin is another antioxidant. Research shows this antioxidant has anti-cancer, antibacterial, antiviral, antifungal, anti-inflammatory, and wound-healing properties. (Mazumder A., Dwivedi A., & du Plessis J. 2016)

Nutrition

A single serving is usually about a teaspoon. A serving of prepared yellow and spicy mustard provides only about three calories. (U.S. Department of Agriculture, 2019) Its nutritional profile includes a rich supply of essential minerals, including calcium, iron, manganese, phosphorus, and zinc. It is also a good source of omega-3 fatty acids, tryptophan, phosphorus, iron, and protein. The seeds are also a very good source of selenium. Most calories come from carbohydrates, but because the calorie count is so low, these carbohydrates are not likely to significantly affect daily intake. Dijon mustard may provide more calories. A single serving of Dijon may contain up to 10 calories.

Preparation and Storage

Yellow mustard and Dijon are easy to find. Try course mustard varieties with distinct textures and seeds. Buy in small quantities, as mustard can lose flavor with time. Once opened, store in the refrigerator for up to one year. Mustard imparts a strong, spicy taste that pairs well with meat and seafood and can also be used to make salad dressings.

Side Effects

The U.S. Food and Drug Administration recognizes mustard as safe (GRAS). Eating too much can cause abdominal pain, diarrhea, and gut inflammation. However, mustard and mustard seed allergies are not uncommon. Symptoms may be mild or severe and generally appear shortly after consuming the product. Individuals may experience a rash or a tingly, itchy feeling in the mouth. Difficulty breathing is also possible. Other foods derived from the mustard plant, including leaves, seeds, and flowers, sprouted seeds, oil, and foods that contain these, are likely to cause reactions in those with mustard allergies.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Enhancing Health Together

References

Mazumder, A., Dwivedi, A., & du Plessis, J. (2016). Sinigrin and Its Therapeutic Benefits. Molecules (Basel, Switzerland), 21(4), 416. https://doi.org/10.3390/molecules21040416

Ewing, Sarah. (1999). Black Mustard (Brassica nigra). https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1421&context=ebl

Palliyaguru, D. L., Yuan, J. M., Kensler, T. W., & Fahey, J. W. (2018). Isothiocyanates: Translating the Power of Plants to People. Molecular nutrition & food research, 62(18), e1700965. https://doi.org/10.1002/mnfr.201700965

U.S. Department of Agriculture. (2019). Mustard, prepared, yellow. Retrieved from https://fdc.nal.usda.gov/food-details/326698/nutrients

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Learn How to Perform Trapezius Self Massage for Pain Relief

Can individuals who sit for long hours daily prevent tight neck and shoulder muscles by improving their posture, regularly stretching, and massaging their trapezius muscles?

Trapezius Self Massage

The trapezius muscle is a triangle-shaped muscle in the upper back that starts at the base of the neck, spans the length of the upper shoulders, and extends into the middle back. This muscle’s main function is stabilizing and moving the scapula/shoulder blade. The trapezius also helps to move the head, neck, arms, shoulders, and torso, stabilizes the spine, and plays an important role in posture. Physical and mental stress can tighten the trapezius muscle, leading to neck and shoulder pain. Learning to perform a trapezius self-massage can ease tension and provide pain relief. (Domingo A. R. et al., 2017)

Anatomy

The trapezius consists of three parts in three different areas of the back. The bottom of the skull, across the shoulders, and down to the mid back. A trapezius self-massage focuses on the upper portion of the traps. This part is located at the top of the shoulders. To find the upper trapezius, cross one arm in front of your body so that you can place the palm on top of the other shoulder.

stock photo trapezius anatomy muscles isolated on white d illustration

For a trapezius self-massage, you need to know that there are two areas where your upper traps start and where the muscle connects to a bone. The first point is on the bottom of the skull, close to the center of the back of the skull. Start there with your fingers and trace the muscle down the back of the neck to where the shoulders widen. If you get lost, You can walk your fingers up or down the muscle on either side to relocate its origin at the base of the skull, the vertebra at the base of your neck that sticks out. This is C-7, another of the upper trapezius’s origin sites. (University of Washington Department of Radiology, 2025) 

Massage Technique

Massage oil is optional but can hydrate the skin during a massage. You can perform the trapezius self-massage using your hands.

Start at the Base of The Neck

Choose one shoulder to work at a time.

  • Raise the arm on the opposite side of your body.
  • Reach this arm across your body and fold it around your neck so that your fingers rest at the back base of your neck.
  • Apply a decent amount of pressure to the muscle while moving your fingers in a circular motion.
  • The action is similar to kneading dough.
  • Massage this area at the base of your neck for about 30 seconds to start.
  • If this part of your muscle is sore, you can massage it longer.

Slowly Work Out Towards The End of The Shoulder

Once you have spent about 30 seconds massaging the muscle at the base of the neck, work your way out toward the end of your shoulder.

  • In close increments, in your fingers across the trapezius muscle, spending at least 30 seconds at each point.
  • Follow the muscle until you reach the end of the shoulder.
  • Apply enough pressure, and use slow, rhythmic movements so that you feel relief.
  • If the pressure is not relieving or makes you wince, it’s too much.

Repeat as Needed

Repeat each side two to three times before switching to the other shoulder. After massaging, you may notice a certain trapezius area is particularly sore or tense. Zero in on those areas a little longer. Remember to relax throughout the trapezius self-massage. This is an opportunity to learn where tension is in your neck and shoulders and how to apply pressure to relieve it. This knowledge can also help you be mindful throughout your day, whether sitting, doing chores, or other physical activities. If you notice scrunching or slouching, massage the trapezius and remind yourself to keep your shoulders relaxed.

Benefits

Tension and tightness in the trapezius muscle are common, particularly among individuals who work in an office, do manual labor, or deal with a lot of stress. (Marker R. J. Campeau S., & Maluf K. S. 2017) Trapezius strains are a common overuse injury that is more likely to happen when the muscle is tight. (Salavati M. et al., 2017) The injury can cause unhealthy posture to avoid the pain. This poor posture will place more stress on the muscles, leading to a cycle of poor posture and chronic pain. A trapezius self-massage can benefit in many ways, including:

  • Improved blood circulation
  • Better quality of sleep
  • Improved posture
  • Improved range of motion
  • Decreased swelling
  • Faster recovery after workouts
  • Reduced risk of injury

Seeing a Healthcare Provider

Like any other muscle in the body, the trapezius can be injured and requires special treatment to recover. Sometimes, the neck or shoulder pain may not come from the trapezius muscle. Consider seeing a healthcare provider if you have pain in your neck or shoulder that doesn’t get better within a week or two, especially if it isn’t responding to at-home treatment. Regardless of how long you have been experiencing pain or stiffness, contact a healthcare provider if it prevents you from getting adequate sleep or interfering with daily activities. Reasons to see a healthcare provider immediately for neck or shoulder pain include: (Mount Sinai, 2025)

  • There is sudden pressure or pain in the left shoulder, which can sometimes signal a heart attack.
  • A fall or accident resulted in pain, swelling, or problems moving the neck or arm.
  • If there is shoulder pain, a fever, swelling, or redness.
  • The skin on the shoulder area appears discolored.

It’s important to take regular breaks to stretch and move your muscles. You can release tension in the trapezius by doing shoulder shrugs throughout the day and stretching regularly. When the trapezius feels tight or sore, give yourself a massage.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Whiplash Chiropractic Massage Therapy

References

Domingo, A. R., Diek, M., Goble, K. M., Maluf, K. S., Goble, D. J., & Baweja, H. S. (2017). Short-duration therapeutic massage reduces postural upper trapezius muscle activity. Neuroreport, 28(2), 108–110. https://doi.org/10.1097/WNR.0000000000000718

University of Washington Department of Radiology. (2025). Trapezius. https://rad.washington.edu/muscle-atlas/trapezius/

Marker, R. J., Campeau, S., & Maluf, K. S. (2017). Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius. Journal of Neurophysiology, 117(1), 457–466. https://doi.org/10.1152/jn.00448.2016

Salavati, M., Akhbari, B., Ebrahimi Takamjani, I., Ezzati, K., & Haghighatkhah, H. (2017). Reliability of the Upper Trapezius Muscle and Fascia Thickness and Strain Ratio Measures by Ultrasonography and Sonoelastography in Participants With Myofascial Pain Syndrome. Journal of Chiropractic Medicine, 16(4), 316–323. https://doi.org/10.1016/j.jcm.2017.06.003

Mount Sinai. (2025). Shoulder pain. https://www.mountsinai.org/health-library/symptoms/shoulder-pain

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How Outcome Measurement Tests Can Guide Treatment

Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?

Outcome Measurement Tests

Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.

Function and Purpose

Outcome measurement tests serve various purposes. These include: (American Physical Therapy Association, N.D.)

  • To assist in goal-setting
  • Provide motivation
  • To guide treatment
  • To give a prognosis for the specific condition
  • To justify the treatment

The physical therapist may use other functional outcome measurements to help assess physical therapy progress.

  • They may measure your strength and range of motion.
  • Balance and posture may be evaluated.

Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.

Common Outcome Measurement Tests Used

Common functional outcome measurement tools that a physical therapist may use include:

  • The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
  • The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
  • The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
  • The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
  • The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues. 
  • The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability. 
  • The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.

Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Understanding The Effects of Personal Injury

References

American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. https://www.apta.org/your-practice/outcomes-measurement

Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf

Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. https://doi.org/10.1038/s41598-022-21547-z

Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. https://doi.org/10.1177/2150131916659282