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Sleep Hygiene

Back Clinic Sleep Hygiene Chiropractic Team. The ideal sleep environment is cool, quiet, and dark. However, research has shown that continuous sleep can be interrupted by uncomfortable room temperature, light, and noises. Proper sleep hygiene specialists may also recommend that you select a comfortable mattress, pillows, and bedding, in addition to moving or hiding a visible clock. This prevents the sleeper from focusing on time passing while trying to fall asleep. Dr. Alex Jimenez describes sleep hygiene as a variety of different habits which are often necessary to achieve a proper quality of sleep to rise with full daytime alertness.

Sleep is essential for an individual’s mental and physical health and well-being because it plays an important role in the body’s natural healing and repairing functions. Therefore, the most important sleeping measure is to maintain regular sleeping patterns. According to Dr. Jimenez, heavy meals before bed, caffeine or alcohol before bed, and even improper sleeping postures accompanied by pain and discomfort can be frequent poor sleep hygiene practices that can interfere with the sleep quality of many individuals. Therefore, the various articles on sleep and sleep hygiene can help provide a useful insight towards improving sleep and overall health.


The Benefits of Sleeping with a Pillow Between the Legs

The Benefits of Sleeping with a Pillow Between the Legs

For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?

The Benefits of Sleeping with a Pillow Between the Legs

Sleep With A Pillow Between The Legs

Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.

The Benefits

Some potential benefits of sleeping with a pillow between the knees.

Reduce Back and Hip Pain

When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.

Reduce Sciatica Symptoms

Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.

Reduce Herniated Disc Symptoms

A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)

Improve Posture

Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)

Pregnancy

Pregnancy pain in the back and pelvic girdle is due to: (Danielle Casagrande et al., 2015)

  • Increased weight leads to increased pressure on joints.
  • Significant change in the center of gravity.
  • Hormonal changes make connective tissues more lax.

Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.

Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.


What Causes Disc Herniation?


References

Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243

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

Penn Medicine. (2024). Herniated disc disorders. Penn Medicine. www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/herniated-disc-disorders

University of Central Florida. (N.D.). The best sleeping position for lower back pain (and the worst). UFC Health Services. ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/

Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582

Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777

University of Rochester Medical Center. (2024). Good sleeping posture helps your back. Health Encyclopedia. www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4460

Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248

Standford Medicine. (2024). Sleeping positions during pregnancy. Standford Medicine Children’s Health. www.stanfordchildrens.org/en/topic/default?id=sleeping-positions-during-pregnancy-85-P01238

O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4

The Effectiveness of Acupuncture for Insomnia Relief

The Effectiveness of Acupuncture for Insomnia Relief

Can acupuncture treatment help individuals dealing with or experiencing insomnia and sleep issues and/or disorders?

The Effectiveness of Acupuncture for Insomnia Relief

Acupuncture For Insomnia

Acupuncture is a type of holistic medicine that involves inserting sterile, disposable, thin needles at specific points known as acupoints on the body. Each needle is inserted into a different area to stimulate symptom relief of various conditions, like chronic pain and nausea. (Johns Hopkins Medicine. 2024) Recent research has looked into acupuncture for insomnia and found that it may be an effective alternative. (Mingming Zhang et al., 2019)

Insomnia

Insomnia causes individuals to have trouble falling or staying asleep. Individuals who have insomnia tend to wake up earlier than they intend to and find it difficult to impossible to get back to sleep once they are awake. The sleep disorder is quite common, with around 10% of individuals experiencing it at some point. (Andrew D. Krystal et al., 2019)

There are three categories, all characterized by the duration of the disorder. They include: (Andrew D. Krystal et al., 2019)

Acute/Short-Term

  • Lasting less than three months.

Episodic

  • Happens once in a while for less than three months.

Chronic

  • Lasting more than three months.

Health Issues

  • Insomnia can cause various health issues, and individuals can develop mood changes, irritability, fatigue, and problems with memory, impulse control, and concentration. (Andrew D. Krystal et al., 2019)
  • Insomnia has also been shown to increase the risk of heart failure, heart attack, and other chronic health conditions. (Mingming Zhang et al., 2019)

Benefits

Studies on the use of acupuncture for insomnia have found that it may improve sleep because of its influence on certain neurotransmitters. One review noted that specific neurotransmitters involved in the sleep-wake cycle are positively affected by acupuncture. (Kaicun Zhao 2013) The neurotransmitters include:

Norepinephrine

  • Helps with waking up and staying alert.

Melatonin

  • A hormone that helps the body calm down and prepare for sleep.

Gamma-aminobutyric acid – GABA

  • Helps the body fall asleep and stay asleep.

However, more research is needed to confirm the benefits of acupuncture for insomnia further.

Conditions

Certain conditions can contribute to insomnia, including:

  • Mood disorders
  • Chronic pain
  • Other sleep disorders

Acupuncture can help lower the effects of these disorders.

Pain

Because of the way acupuncture affects certain chemicals, it is a proven complementary treatment for pain.

  • The needles enhance chemicals like endorphins, dynorphins, and encephalins.
  • Acupuncture also releases corticosteroids, which are stress hormones.
  • Each of these chemicals has a role in pain symptoms.
  • Adjusting their levels helps reduce pain. (Shilpadevi Patil et al., 2016)

Anxiety

  • Studies have found that individuals with anxiety can also benefit from acupuncture to help reduce symptoms. (Meixuan Li et al., 2019)

Sleep Apnea

  • Sleep apnea is a sleep-breathing disorder that causes an individual to stop breathing during the night temporarily.
  • The muscles in the nasal cavity, nose, mouth, or throat become overly relaxed.
  • Acupuncture can help stimulate the muscles and prevent over-relaxation, preventing apneas.
  • Data suggests that acupuncture may affect the apnea-hypopnea index, the number of times an individual stops and starts breathing during sleep. (Liaoyao Wang et al., 2020)

Session

  • Individuals should not feel pain and just a small amount of pressure in the needles’ insertion area.
  • If pain is present, it could be because the needles are not inserted in the right spot.
  • It’s essential to tell the acupuncturist so they can reset and re-insert them correctly. (Malcolm W. C. Chan et al., 2017)

Side Effects

Side effects are rare but can occur. These include: (G. Ernst, H. Strzyz, H. Hagmeister 2003)

  • Dizziness
  • Bleeding or bruising where the needle was inserted.
  • Nausea
  • Fainting
  • Pins and needles sensation
  • Feeling more pain  treatment

Prior to getting acupuncture, individuals are recommended to speak to their healthcare provider. They can advise on how it can help and any side effects that may occur due to the individual’s health, underlying conditions, and medical history. Once cleared, they can recommend a licensed acupuncturist.


Tension Headaches


References

Johns Hopkins Medicine. (2024). Acupuncture (Health, Issue. www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

Zhang, M., Zhao, J., Li, X., Chen, X., Xie, J., Meng, L., & Gao, X. (2019). Effectiveness and safety of acupuncture for insomnia: Protocol for a systematic review. Medicine, 98(45), e17842. doi.org/10.1097/MD.0000000000017842

Krystal, A. D., Prather, A. A., & Ashbrook, L. H. (2019). The assessment and management of insomnia: an update. World psychiatry: official journal of the World Psychiatric Association (WPA), 18(3), 337–352. doi.org/10.1002/wps.20674

Zhao K. (2013). Acupuncture for the treatment of insomnia. International review of neurobiology, 111, 217–234. doi.org/10.1016/B978-0-12-411545-3.00011-0

Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. doi.org/10.1007/s11916-016-0552-1

Li, M., Xing, X., Yao, L., Li, X., He, W., Wang, M., Li, H., Wang, X., Xun, Y., Yan, P., Lu, Z., Zhou, B., Yang, X., & Yang, K. (2019). Acupuncture for treatment of anxiety, an overview of systematic reviews. Complementary therapies in medicine, 43, 247–252. doi.org/10.1016/j.ctim.2019.02.013

Wang, L., Xu, J., Zhan, Y., & Pei, J. (2020). Acupuncture for Obstructive Sleep Apnea (OSA) in Adults: A Systematic Review and Meta-Analysis. BioMed research international, 2020, 6972327. doi.org/10.1155/2020/6972327

Chan, M. W. C., Wu, X. Y., Wu, J. C. Y., Wong, S. Y. S., & Chung, V. C. H. (2017). Safety of Acupuncture: Overview of Systematic Reviews. Scientific reports, 7(1), 3369. doi.org/10.1038/s41598-017-03272-0

Ernst, G., Strzyz, H., & Hagmeister, H. (2003). Incidence of adverse effects during acupuncture therapy-a multicentre survey. Complementary therapies in medicine, 11(2), 93–97. doi.org/10.1016/s0965-2299(03)00004-9

Sleep Better with These Tips for Bed Mobility

Sleep Better with These Tips for Bed Mobility

Individuals in post-surgery recovery or dealing with illness or an injury can experience weakened muscles and endurance that can cause temporary loss of sleeping mobility and not being able to move around normally because of weakness, decreased range of motion, or pain. Can they benefit from physical therapy to help get back to normal functional mobility?

Sleep Better with These Tips for Bed Mobility

Sleeping Mobility

For individuals who are hospitalized or homebound from injury, illness, or surgical recovery, a physical therapist will assess various areas of functional mobility. These include transfers – from sitting to standing positions, walking, and sleeping mobility. Sleeping mobility is the ability to perform specific motions while in bed. A therapist can assess sleeping or bed mobility and recommend strategies and exercises to improve movements. (O’Sullivan, S. B., Schmitz, T. J. 2016) A therapist may have the individual use specific devices, like an over-the-bed trapeze or a sliding board, to help move around.

Bed and Sleeping Mobility

When a physical therapist checks mobility, they will assess various motions that include: (O’Sullivan, S. B., Schmitz, T. J. 2016)

  • Moving from sitting to lying down.
  • Moving from lying down to sitting up.
  • Rolling over.
  • Scooting or sliding up or down.
  • Scooting or sliding sideways.
  • Twisting.
  • Reaching.
  • Raising the hips.

All of these movements require strength in different muscle groups. By checking out individual motions in sleeping mobility, a therapist can work out specific muscle groups that may be weak and require targeted exercises and stretches to restore mobility to normal. (O’Sullivan, S. B., Schmitz, T. J. 2016) Individuals visiting a therapist in an outpatient clinic or rehabilitation area may have the individual work on sleeping mobility on a treatment table. The same motions on the treatment table can be done in the bed.

Importance

The body is meant to move.

For individuals who cannot move comfortably on their bed, the body may suffer disuse atrophy or the wasting away of muscular strength, which can lead to increased difficulties. Not being able to move can also lead to pressure ulcers, especially for individuals who are severely deconditioned and/or remain in one position for a long period. Skin health may start to break down, leading to painful wounds that require specialized care. Being able to move around in bed can help prevent pressure ulcers. (Surajit Bhattacharya, R. K. Mishra. 2015)

Improvement

A physical therapist can prescribe specific exercises to strengthen muscle groups and improve sleeping mobility.  The muscles include:

  • Shoulder and rotator cuff muscles.
  • Triceps and biceps in the arms.
  • Gluteus muscles of the hips.
  • Hamstrings
  • Quadriceps
  • Calf muscles

The shoulders, arms, hips, and legs work together when moving the body around the bed.

Various Exercises

To improve bed movement, physical therapy exercises can include:

  • Upper extremity exercises
  • Lower trunk rotation
  • Glute exercises
  • Bridges
  • Leg raises
  • Short arc quads
  • Ankle pumps

Physical therapists are trained to assess these motions and functions and prescribe treatments to improve body movement. (O’Sullivan, S. B., Schmitz, T. J. 2016) Maintaining appropriate physical fitness can help the body stay active and mobile. Performing mobility exercises prescribed by a physical therapist can keep the right muscle groups working properly, and working with a physical therapist can ensure the exercises are correct for the condition and are performed properly.


Optimizing Your Wellness


References

O’Sullivan, S. B., Schmitz, T. J. (2016). Improving Functional Outcomes in Physical Rehabilitation. United States: F.A. Davis Company.

Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 48(1), 4–16. doi.org/10.4103/0970-0358.155260

Learning To Sleep On Your Back

Learning To Sleep On Your Back

Individuals spend around one-third of their life sleeping or resting. Every person has their own preferred sleeping position. However, not all sleep positions are comfortable and supportive to the body, especially the spine. Individuals that sleep on their side or stomach that experience back pain might want to consider switching to sleeping on their back. Changing preferred sleeping positions can seem impossible,  however, learning to sleep on your back is possible with a little training and adjustment period.

Learning To Sleep On Your Back

Learning To Sleep On Your Back

After side sleeping, back sleeping is the second most common position. Individuals that are stomach or side sleepers that suffer from:

  • Body and back soreness.
  • Pain symptoms.
  • Tension headaches.
  • Heartburn or acid reflux.
  • Aches in the joints and ligaments.

Learning to sleep on your back is recommended because its health benefits can potentially solve all these problems and more.

  • Adapting this sleeping position can help maintain proper spinal alignment.
  • Relieves waking up with tension headaches.
  • Relieve sinus problems.

Individuals that are not natural back sleepers understand how difficult it is to force oneself to adapt to a new sleeping position. There are ways to condition the mind and body to fall and stay asleep on your back, resulting in healthy rest. These include:

A Pillow Under The Knees

  • It may help to place a supportive pillow under the knees.
  • The knees should be slightly bent and feel comfortable.
  • Check to make sure that the neck and spine feel comfortable and are in alignment.
  • Make adjustments as needed.

A Pillow Under The Low Back

  • In the beginning, switching to back sleeping can increase discomfort in the low back.
  • Placing a pillow under the lower back can help.
  • Using too large or thick a pillow could create added discomfort.
  • Try a few different pillows to find what works best and feels right.

Pillow Surround

  • Individuals that are active sleepers and tend to roll onto their side or stomach soon after falling asleep, can place pillows around the midsection and hips.
  • A small barrier of pillows around the body can assist in learning to sleep on your back.
  • The pillows help prevent the body from rolling.
  • It’s recommended to place pillows closely against either side of the body.
  • Using the pillows as an enclosure will force the body to remain in a neutral position throughout the night.

Sleeping On The Right Pillow

  • Individuals will want to make sure they are using the right sleeping pillow.
  • In addition to supporting the spine’s alignment, a quality pillow will also support the neck.
  • The recommended pillow for back sleeping should cradle the head and ensure it stays elevated.
  • A pillow that is too flat or too thick can cause the head to become unlevel with the body leading to:
  • Neck and upper body pain
  • Restricted airflow, which may cause you to snore or suffer from sleep apnea.
  • Digestive issues like acid reflux and heartburn.
  • Consider a pillow that’s made out of some type of memory foam to assist with learning to sleep on your back.
  • The thickness and hugging sensation can help to stay on the back and prevent inadvertently flipping over.

Sleeping On The Right Mattress

A positive back sleeping experience begins with the right mattress. There are so many mattress types to choose from. It is recommended to consider the materials, the firmness level, and the size. For comfortably sleeping on your back, the firmness level is essential.

  • Consider the positioning of your spine.
  • The objective is to keep the spine as straight as possible, which is achieved with the proper firmness.
  • A mattress that is too firm will create unwanted pressure and tension on the shoulders and the pelvic region.
  • A mattress that is too soft will cause the hips to sink, throwing spinal alignment off and causing back pain symptoms.
  • A medium-firm mattress is recommended.
  • Memory foam is a great option for learning to sleep on your back.
  • Memory foam cradles the natural curve of the body, and hugs the body during sleep, which helps avoid accidentally rolling onto your side or stomach.
  • Memory foam mattresses with integrated gel can provide cooling and ventilation to keep the body refreshed throughout the night.
  • A medium-firm memory foam mattress will make sure the body stays straight, with the proper cushioning around the pelvis and hips.

Training To Sleep On Your Back


References

Anderson, Ngaire H et al. “Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis.” JAMA network open vol. 2,10 e1912614. 2 Oct. 2019, doi:10.1001/jamanetworkopen.2019.12614

Desouzart, Gustavo, et al. “Effects of sleeping position on back pain in physically active seniors: A controlled pilot study.” Work (Reading, Mass.) vol. 53,2 (2015): 235-40. doi:10.3233/WOR-152243

Khan, Bashir Ahmad, et al. “Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux.” Journal of Gastroenterology and Hepatology vol. 27,6 (2012): 1078-82. doi:10.1111/j.1440-1746.2011.06968.x

Portale, G et al. “When are reflux episodes symptomatic?.” Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus vol. 20,1 (2007): 47-52. doi:10.1111/j.1442-2050.2007.00650.x

Skarpsno, Eivind Schjelderup, et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and Science of Sleep vol. 9 267-275. 1 Nov. 2017, doi:10.2147/NSS.S145777

Surdea-Blaga, Teodora, et al. “Food and Gastroesophageal Reflux Disease.” Current medicinal chemistry vol. 26,19 (2019): 3497-3511. doi:10.2174/0929867324666170515123807

Overtraining Syndrome: El Paso Back Clinic

Overtraining Syndrome: El Paso Back Clinic

Individuals can become overly passionate about exercising. However, constantly training the body without taking enough time to rest and recover can impact athletes and fitness enthusiasts physically and mentally and lead to overtraining syndrome. Excessive training can cause decreases in athletic physical performance that can be long-lasting, sometimes taking several weeks or months to recover. Individuals who don’t learn to manage overtraining can have injuries and more frequent illnesses and infections. And the psychological effects can also lead to negative mood changes. Learn the signs and how to cut back to prevent injury and/or burnout.

Overtraining Syndrome: EP's Chiropractic Injury Team

Overtraining Syndrome

Athletes and fitness lovers often exercise longer and harder than average to reach peak performance. Even individuals just getting started with exercise can push their limits as they try to figure out what works for them. This means taking into consideration the following:

  • The mental side of training.
  • How to get and stay motivated.
  • How to set up a safe and effective program with balanced cardio and strength training.
  • How to avoid skipping workouts when things get in the way.
  • Exercising too much is a mistake many beginners make, putting themselves at risk for injury.

Overtraining syndrome is when the body goes through and feels:

  • Extreme fatigue.
  • Physical performance problems.
  • Mood changes.
  • Sleep disturbances.
  • Other issues due to working out or training too much and/or too hard without giving the body enough time to rest.

Overtraining is common among athletes who train beyond their body’s ability to recover, usually when preparing for a competition or event. Conditioning for athletes and enthusiasts requires a balance between work and recovery.

Signs and Symptoms

There are several signs to look for, with the more common symptoms being:

  • Mild muscle or joint soreness, general aches, and pains.
  • Decreased training capacity, intensity, or performance.
  • Lack of energy, constantly tired, and/or drained.
  • Brain fog.
  • Insomnia.
  • Decreased appetite or weight loss.
  • Loss of enthusiasm for the sport or exercise.
  • Irregular heart rate or heart rhythm.
  • Increased injuries.
  • Increased headaches.
  • Feeling depressed, anxious, or irritable.
  • Sexual dysfunction or decreased sex drive.
  • Lower immunity with an increase in colds and sore throats.

Prevent Overtraining

  • Predicting whether there is a risk of overtraining can be tricky because every person responds differently to various training routines.
  • Individuals have to vary their training throughout and schedule adequate time for rest.
  • Individuals who believe they may be training too hard should try the following strategies to prevent overtraining syndrome.

Take Note of Mental and Mood Changes

Methods exist to test for overtraining objectively.

  • One is taking note of psychological signs and symptoms associated with changes in an individual’s mental state can be an indicator.
  • Decreased positive feelings for exercise, physical activities, and sports.
  • Increased negative emotions, like depression, anger, fatigue, and irritability, can appear after a few days of intense training.
  • If these feelings and emotions begin to present, it is time to rest or dial the intensity down.

Training Log

  • A training log that notes how the body feels daily.
  • It can help individuals notice downward trends and decreased enthusiasm.
  • This can help individuals learn to listen to their body’s signals and rest when necessary.

Monitor Heart Rate

  • Another option is to track changes in heart rate over time.
  • Monitor heart rate at rest and specific exercise intensities while training, and record it.
  • If the heart rate increases at rest or a given intensity, this could be a risk indicator, especially if symptoms develop.
  • Track resting heart rate each morning.
  • Individuals can manually take a pulse for 60 seconds immediately after waking up.
  • Individuals can also use a heart rate monitor or fitness band.
  • Any marked increase from the norm may indicate that the body has not fully recovered.

Treatment

Rest and Recovery

  • Reduce or stop the exercise and allow the mind and body a few rest days.
  • Research on overtraining shows that complete rest is the primary treatment.

Take Extra Rest Days

  • Starting anything new will usually make the body sore.
  • Be prepared for the aches and take extra rest days when needed.
  • The body won’t have the same energy levels from day to day or even from week to week.

Consult A Trainer

  • Not sure where to start or how to approach working out safely.
  • This is the time to meet with a professional who can look at physical and medical history, fitness level, and goals.
  • They can develop a customized program to meet specific needs.

Nutrition and Hydration

  • Maintain optimal body hydration with plenty of H2O/water and rehydrating drinks, vegetables, and fruits.
  • Staying properly hydrated is key to both recovery and prevention.
  • Getting enough protein and carbohydrates supports muscle recovery.
  • Carbs are important for endurance, and protein is important for muscular strength and power.

Sports Chiropractic Massage

  • Research shows that sports massage benefits muscle recovery and can improve delayed onset muscle soreness/DOMS.
  • Massage keeps muscles loose and flexible and increases blood circulation for expedited recovery.

Relaxation Techniques

  • Stress-reduction techniques such as deep breathing and progressive muscle relaxation exercises can improve rest and recovery.

Total recovery from overtraining syndrome can take a few weeks or longer, depending on the individual’s health status and how long the excessive training has gone on. A physician can refer individuals to a physical therapist or sports chiropractor, who can develop a personalized recovery plan to get the body back to top form.


Military Training and Chiropractic


References

Bell, G W. “Aquatic sports massage therapy.” Clinics in sports medicine vol. 18,2 (1999): 427-35, ix. doi:10.1016/s0278-5919(05)70156-3

Carrard, Justin, et al. “Diagnosing Overtraining Syndrome: A Scoping Review.” Sports Health vol. 14,5 (2022): 665-673. doi:10.1177/19417381211044739

Davis, Holly Louisa, et al. “Effect of sports massage on performance and recovery: a systematic review and meta-analysis.” BMJ open sport & exercise medicine vol. 6,1 e000614. 7 May. 2020, doi:10.1136/bmjsem-2019-000614

Grandou, Clementine, et al. “Symptoms of Overtraining in Resistance Exercise: International Cross-Sectional Survey.” International Journal of sports physiology and Performance vol. 16,1 (2021): 80-89. doi:10.1123/ijspp.2019-0825

Meeusen, Romain, et al. “Brain neurotransmitters in fatigue and overtraining.” Applied physiology, nutrition, and metabolism = Physiologie applique, nutrition et metabolisme vol. 32,5 (2007): 857-64. doi:10.1139/H07-080

Peluso, Marco Aurélio Monteiro, and Laura Helena Silveira Guerra de Andrade. “Physical activity and mental health: the association between exercise and mood.” Clinics (Sao Paulo, Brazil) vol. 60,1 (2005): 61-70. doi:10.1590/s1807-59322005000100012

Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004

Nocturnal Leg Cramps: El Paso Back Clinic

Nocturnal Leg Cramps: El Paso Back Clinic

Lying down on the couch or bed when the lower leg seizes with intense sensations and pain that doesn’t stop, and the muscle could be hard to the touch. When trying to move the leg, it feels paralyzed. Nocturnal leg cramps, called muscle spasms or Charley horses, occur when one or more leg muscles tighten involuntarily. Individuals can be awake or asleep when a leg cramp strikes. Chiropractic treatment, decompression, and massage therapies can help relieve symptoms, stretch and relax the muscles, and restore function and health.

Nocturnal Leg Cramps: EP' Chiropractic Specialists

Nocturnal Leg Cramps

Nocturnal leg cramps most often affect the gastrocnemius/calf muscle. However, they can also affect the muscles in the front of the thigh/quadriceps and the back of the thigh/hamstrings.

  • Often, the tight muscle relaxes in less than 10 minutes.
  • The leg and area can feel sore and tender afterward.
  • Frequent calf cramps at night can cause sleep problems.
  • Nocturnal leg cramps are more common among women and older adults.

Causes

There are no known exact cause/s, making most cases idiopathic. However, there are known factors that can increase the risk. These can include:

Prolonged Sitting and Position

  • Sitting with the legs crossed or the toes pointed for long periods shortens/pulls the calf muscles, which can cause cramping.

Prolonged Standing and Posture

  • Individuals standing for long periods are likelier to experience nocturnal cramps from the stressed muscles.

Muscle Overexertion

  • Too much exercise can create an overworked muscle and can contribute to cramps.

Nerve Activity Abnormalities

Lack of Physical/Exercise Activity

  • Muscles need to be stretched regularly to function correctly.
  • Lack of physical activity for long periods weakens the muscles, making them more susceptible to injury.

Shortening The Tendons

  • The tendons, which connect muscles and bones, shorten naturally over time.
  • Without stretching, this could lead to cramping.
  • Cramps may be related to foot position when sleeping, with the feet and toes extending away from the body, known as plantar flexion.
  • This shortens the calf muscles, making them more susceptible to cramping.

Leg cramps at night are unlikely a sign of a more serious medical condition, but they are associated with the following conditions:

  • Musculoskeletal disorders.
  • Structural issues – flat feet or spinal stenosis.
  • Metabolic disorders like diabetes.
  • Pregnancy.
  • Medications – statins and diuretics.
  • Neurological disorders, like motor neuron disease or peripheral neuropathy.
  • Neurodegenerative disorders.
  • Liver, kidney, and thyroid conditions.
  • Cardiovascular conditions.

Chiropractic and Physical Therapy

Rehabilitation with chiropractic, massage, and physical therapy depends on the severity of the injury and condition. A chiropractic treatment plan can include the following:

  • Calf muscle stretching.
  • Targeted Stretch Exercises.
  • Progressive calf stretching exercises – a regular stretching and flexibility program will increase the range of motion and prevent future calf injuries.
  • Foam rolling – gentle self-massage with a foam roller can help reduce spasms and improve blood circulation.
  • Percussive massage.
  • Muscle strengthening exercises will build muscle strength and coordination to prevent future strain injuries.

At-home therapy can include:

Maintain Hydration

  • Fluids allow for normal muscle function.
  • Individuals may need to adjust how much fluid is drunk based on weather, age, activity level, and medications.

Change Sleeping Position

  • Individuals should avoid sleeping in positions in which the feet are pointing downward.
  • Try sleeping on the back with a pillow behind the knees.

Self Massage

  • Massaging the affected muscles will help them relax.
  • Use one or both hands or a massage gun to knead and loosen the muscles gently.

Stretching

  • Various stretches will maintain the treatment, help keep the muscles relaxed and retrain the muscles.

Stationary Cycle

  • A few minutes of easy pedaling can help loosen the leg muscles before bed.

Walking on the Heels

  • This will activate the muscles on the other side of the calf, allowing the calves to relax.

Supportive Footwear

  • Poor footwear can aggravate issues with the nerves and muscles in the feet and legs.
  • Orthotics may help.

Heat Application

  • Heat can soothe tight muscles and increases blood flow to the area.
  • Apply a hot towel, water bottle, heating pad, or muscle topical cream to the affected area.
  • A warm bath or shower (if available, shower massage setting) can also help.

Sciatica Secrets Revealed


References

Allen, Richard E, and Karl A Kirby. “Nocturnal leg cramps.” American family physician vol. 86,4 (2012): 350-5.

Butler, J V et al. “Nocturnal leg cramps in older people.” Postgraduate medical journal vol. 78,924 (2002): 596-8. doi:10.1136/pmj.78.924.596

Garrison, Scott R et al. “Magnesium for skeletal muscle cramps.” The Cochrane Database of systematic reviews vol. 2012,9 CD009402. Sep 12, 2012, doi:10.1002/14651858.CD009402.pub2

Giuffre BA, Black AC, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2023 May 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482431/

Handa, Junichi, et al. “Nocturnal Leg Cramps and Lumbar Spinal Stenosis: A Cross-Sectional Study in the Community.” International Journal of general medicine vol. 15 7985-7993. Nov 1 2022, doi:10.2147/IJGM.S383425

Hsu D, Chang KV. Gastrocnemius Strain. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK534766/

Mayo Clinic Staff. (2019). Night leg cramps. mayoclinic.org/symptoms/night-leg-cramps/basics/causes/sym-20050813

Monderer, Renee S et al. “Nocturnal leg cramps.” Current Neurology and Neuroscience report vol. 10,1 (2010): 53-9. doi:10.1007/s11910-009-0079-5

Late Night Healthy Nutritious Snacks: El Paso Back Clinic

Late Night Healthy Nutritious Snacks: El Paso Back Clinic

With the summer approaching, the day’s heat makes the body want to eat light or not at all. That’s when late-night hunger kicks in. Individuals can’t sleep because their stomachs won’t stop growling. Whatever the reason, the body needs something to eat to go back to sleep. The challenge is figuring out what’s quick, tasty, healthy, and can help promote sleep, as some foods contain compounds that can improve sleep.

Late Night Healthy Nutritious Snacks: EP Chiropractic Clinic

Late-Night Nutritious Snacks

There are several reasons for needing a late-night snack, and a healthy snack can be a good way to get some additional nutrients for the next day. Having small nutrient-rich snacks under 200 calories is fine. Individuals who regularly have late-night snacks should consider having prepared snacks to promote sleep and not inhibit sleep. Planning is the key to choosing snacks to help support healthy sleep and satisfy hunger.

Snacks To Consider

Pumpkin Seeds

  • Pumpkin contains tryptophan which contributes to sleep.
  • They also contain essential nutrients zinc, phosphorus, potassium, selenium, and magnesium.
  • These can help combat illnesses related to inflammation.

Bananas

  • Bananas are a healthy source of dietary melatonin.
  • In one study, individuals who ate a banana had an increase in serum melatonin levels two hours after eating.
  • The potassium content of bananas can help inhibit muscle cramps, a problem some individuals have when trying to sleep.

Glass of Milk

  • Warm or cold, a glass of milk before bed can help improve sleep.
  • Milk contains antioxidant and anti-inflammatory properties, which can help improve sleep quality.
  • Sleep-inducing amino acids like tryptophan are also found in milk.
  • Dairy milk is not the only type of milk shown to aid sleep.
  • Soy milk is a good source of both melatonin and tryptophan.
  • Plant-based milk made with nuts can confer the same benefits as whole nuts.

Milk and Cereal

  • Individuals may reserve cereal for breakfast, but it can make a healthy late-night snack to promote sleep.
  • One study found that high-glycemic carbs in many corn-based cereals before bed reduced the time it took to fall asleep.
  • Limit portion size as the entire snack should be under 300 calories, especially for those with heartburn, as a heavy meal can exacerbate the problem.
  • Dairy products contain calcium, a mineral that directly produces the sleep hormone melatonin and is a natural relaxant in the body.

Peanut Butter and Jelly Sandwich

  • Foods like peanut butter contain an amino acid called tryptophan, which is converted into melatonin to promote sleepiness.
  • Carbohydrates like bread and jelly help make tryptophan more available to the brain.
  • Option for whole grain bread and natural peanut butter with no added sugars for added nutrition.

Yogurt with Fruit

  • Plain yogurt with berries, chopped nuts, and honey.
  • Yogurt provides a healthy source of calcium, which has been linked to better sleep.
  • Be sure to read the labels, as some varieties contain added sugar.

Fruit and Nuts

  • Fruit and nuts are great when hungry and tired.
  • They provide nutritional benefits, including vitamins, minerals, protein, complex carbs, healthy fats, and fiber.
  • They nourish, provide satisfaction, and help the body fall asleep.
  • An apple with a handful of almonds, a banana, and pecans, or a pear with a few walnuts.
  • One teaspoon of peanut butter on banana slices or dip apple slices in almond butter.
  • If almond butter is too thick for dipping, microwave 1-2 tablespoons for 30 seconds until it’s soft enough to dip.

Popcorn

  • Popcorn is a great snack that is low in calories.
  • Three cups of air-popped popcorn have fewer than 100 calories and about 4 grams of fiber.
  • Skip the butter and mix in dried spices for extra flavor.

Vegetables and Dip

  • Craving something crunchy and low-calorie, fresh vegetables and dip.
  • Any combination of raw carrots, broccoli florets, cucumber slices, celery, zucchini, peppers, and grape tomatoes can satisfy a rumbling stomach.
  • Enhance the flavor with a plain low-fat cottage cheese dip, Greek yogurt, or hummus.

Turkey Sandwich

  • When craving a sandwich, a combination of protein and complex carbohydrates from lean protein like turkey and whole grain bread with tomato, lettuce, and a splash of mayo and mustard can satisfy.
  • Allow enough time to digest, as being too full can inhibit sleep.

Mediterranean Nachos

  • Top toasted healthy corn or pita chips with hummus, paprika, and red pepper for a crunchy and satisfying late-night snack to help the body fall asleep.
  • Chickpeas, the primary ingredient in hummus, contain tryptophan.

Body In Balance


References

Bandín, C et al. “Meal timing affects glucose tolerance, substrate oxidation, and circadian-related variables: A randomized, crossover trial.” International Journal of Obesity (2005) vol. 39,5 (2015): 828-33. doi:10.1038/ijo.2014.182

Beccuti, Guglielmo, et al. “Timing of food intake: Sounding the alarm about metabolic impairments? A systematic review.” Pharmacological research vol. 125, Pt B (2017): 132-141. doi:10.1016/j.phrs.2017.09.005

Behrouz, Sepide, et al. “The Antioxidant, Anti-Inflammatory, and Immunomodulatory Effects of Camel Milk.” Frontiers in immunology vol. 13 855342. 12 Apr. 2022, doi:10.3389/fimmu.2022.855342

Gallant, Annette, et al. “Nutritional Aspects of Late Eating and Night Eating.” Current obesity reports vol. 3,1 (2014): 101-7. doi:10.1007/s13679-013-0081-8

Stobiecka, Magdalena, et al. “Antioxidant Activity of Milk and Dairy Products.” Animals: an open access journal from MDPI vol. 12,3 245. 20 Jan. 2022, doi:10.3390/ani12030245