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Choosing the Right Exercise Ball for an Optimal Workout

Choosing the Right Exercise Ball for an Optimal Workout

For individuals wanting to improve core stability, can using the right size exercise or stability ball help improve workouts and achieve goals?

Get Fit and Improve Your Posture with an Exercise Stability Ball

Exercise Stability Ball

An exercise ball, stability ball, or Swiss ball is a piece of fitness equipment used in gyms, Pilates and yoga studios, and HIIT classes. (Fono a Amerika i Fa'amalositino. 2014) It is inflated with air to supplement bodyweight workouts or improve posture and balance. It can also be used as a chair. They add a core stability challenge to almost any exercise (American Council on Exercise, N.D.) Getting the appropriate exercise ball size and firmness for your body and purpose will ensure an optimal workout.

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  • The exercise ball size should be proportional to individual height.
  • Individuals should be able to sit on the ball with their legs at a 90-degree angle or slightly more, but not less.
  • The thighs should be parallel to the ground or angled slightly down.
  • With the feet flat on the floor and the spine straight, not leaning forward, backward, or sideways, the knees should be even with or slightly lower than the hips.

Here is the American Council on Exercise guide when choosing. (Fono a Amerika i Fa'amalositino. 2001)

Height – Ball Size

  • Under 4’6”/137 cm – 30 cm/12 inches
  • 4’6” – 5’0”/137-152 cm – 45 cm/18 inches
  • 5’1”-5’7”/155-170 cm –  55 cm/22 inches
  • 5’8”-6’2”/173-188 cm – 65 cm/26 inches
  • Over 6’2”/188 cm – 75 cm/30 inches

Getting the right exercise ball for weight is also important. Individuals who are heavy for their height may need a larger ball to keep the knees and legs at the correct angle. It is recommended to check the weight rating of the ball, its durability, and its high burst resistance before buying.

Faʻamatalaga

Individuals want a little give on the ball’s surface for exercise. When sitting on the exercise stability ball, body weight should create a little seat and provide more stability. More importantly, it allows sitting evenly on the ball, which is essential for exercising with proper spinal alignment. (Rafael F. Escamilla et al., 2016) Inflation is a matter of preference, but the more inflated the ball is, the more difficult it will be to balance the body, whether sitting or in other positions. It is recommended not to over-inflate the ball at the risk of bursting. The ball may require reinflation occasionally, so many are sold with a small pump for this purpose.

Faamalositino ma Faʻaloaloa

Exercise balls are highly versatile, inexpensive, and easy-to-use workout tools. They are beneficial for improving core strength and stability. Ways to be used include:

  • Active sitting in place of a chair.
  • Stretching on the ball.
  • Balance and stability exercises.
  • Pilates or yoga.
  • Strength workout.
  • Target exercises for core activation and strengthening.

At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These natural programs use the body’s ability to achieve improvement goals and athletes can condition themselves to excel in their sport through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.


Fa'amalositino ile Fale mo le Toomaga o Tiga


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American Council on Exercise. Sabrena Jo. (2014). Core-strengthening Stability Ball Workout. ACE Fitness® & Healthy Lifestyle Blog. www.acefitness.org/resources/pros/expert-articles/5123/core-strengthening-stability-ball-workout/

American Council on Exercise. (N.D.). Exercise Database & Library. Featured Exercises from ACE. Stability Ball. Healthy Living Blog. www.acefitness.org/resources/everyone/exercise-library/equipment/stability-ball/

American Council on Exercise. (2001). Strengthen your abdominals with stability balls. Healthy Living Blog. acewebcontent.azureedge.net/assets/education-resources/lifestyle/fitfacts/pdfs/fitfacts/itemid_129.pdf

Escamilla, R. F., Lewis, C., Pecson, A., Imamura, R., & Andrews, J. R. (2016). Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball. Sports health, 8(4), 372–379. doi.org/10.1177/1941738116653931

Footwear for Back Pain Relief: Choosing the Right Shoes

Footwear for Back Pain Relief: Choosing the Right Shoes

Footwear can cause lower back pain and problems for some individuals. Can understanding the connection between footwear and back problems help individuals find the right shoes to maintain back health and relieve pain?

Footwear for Back Pain Relief: Choosing the Right Shoes

Footwear Back Pain

The back provides the strength for physical activities. Back pain affects daily life and can have various causes. Unhealthy posture, walking, twisting, turning, bending, and reaching can contribute to back problems that result in pain. According to the CDC, 39% of adults report living with back pain (Centres for Control Control and Prevention, 2019). Improper footwear can also contribute to back pain. Selecting footwear carefully can help bring pain relief and help maintain spinal health. Individuals can enjoy less pain and manage symptoms by choosing shoes that maintain spinal alignment and protect the feet from blunt impact.

Understanding the Back Pain-Footwear Connection

Improper footwear could be the cause of lower back pain. What impacts the bones at the bottom of the neuromusculoskeletal system radiates upward and affects the spine and back muscles. What footwear is used travels upward, impacting gait, posture, spinal alignment, and more. When back problems originate from the feet, these are biomechanical issues. Biomechanics means how the bones, joints, and muscles work together and how changes in external forces impact the body.

gāoioiga

When the feet impact the ground, they are the first extremities to absorb shock for the rest of the body. Individuals will start to walk differently if they have a problem or change in their feet. Wearing shoes with improper support can increase the wear and tear on the muscles and joints, leading to awkward and unnatural movement. For example, consider the difference between standing on tiptoes in high heels and the natural flat-footed state. Well-cushioned shoes help absorb impact and lessen pain sensations. The pressures on each of the joints shift balance, which causes instability problems with less pressure on some and more on others. This creates an imbalance that leads to pain and joint conditions.

Faʻailoga

Maintaining a healthy posture is another factor in preventing or alleviating back pain. With the right footwear, the body can maintain a healthier stance and the right curvature throughout the spine, and it helps distribute the weight evenly. This results in decreased stress on ligaments, muscles, and joints. (Harvard Health Publishing. 2014) It’s recommended to see an orthopedist to get to the root of an individual’s condition. For some, a herniated disc, sciatica, automobile collision, fall, unhealthy ergonomics, or a combination, as well as other underlying issues, may be contributing to their back pain.

Shoe Types and Their Impact on The Back

How various shoes impact posture, potentially causing or relieving back pain.

Muli uumi

High heels can definitely contribute to back pain. They change body posture, causing a domino effect on the spine. The body’s weight is shifted to increase pressure on the balls of the feet, and the spine’s alignment becomes altered. High heels also affect how the ankles, knees, and hips move when walking, balance, and how the back muscles operate, all of which can worsen back pain.

Seevae mafolafola

Flat shoes may not be the best choice for spinal health. If they lack arch support, they can cause the foot to roll inward, known as pronation. This can contribute to misalignment, which can strain the knees, hips, and lower back. However, they can be a decent choice if they provide arch support. When wearing flat shoes with healthy support, the weight is distributed evenly on the feet and the spine. This helps maintain correct posture, which can help prevent and/or alleviate back pain.

Sneakers, Tennis, and Athletic Shoes

Sneakers, tennis, and seevae afeleti can relieve back pain with thorough cushioning and support. Choosing the right ones involves determining the activity that will be done in them. There are tennis, running, basketball, pickleball, skating shoes, and more. Research what features will be needed for the sport or activity. This could include:

  • Heel cups
  • Insole cushioning
  • Wide base
  • Other features to meet individual foot needs.

It is recommended that athletic shoes be changed every 300 to 500 miles of walking or running or with any signs of unevenness when placed on a flat surface, as worn-out soles and degraded materials can increase the risk of injury and back pain. (American Academy of Podiatric Sports Medicine, 2024).  If a certain pair puts the legs, hips, or ankles into an unnatural position or impedes regular movement, it may be time to replace them.

Filifilia o seevae Sa'o

The ideal solution for choosing shoe wear is to get a gait analysis and a review of how you walk and run. Various healthcare professionals may offer this service to tailor each individual’s search for the right shoes for back pain. In gait analysis, individuals are asked to run and walk, sometimes on camera, while a professional notes physical tendencies, like when the foot hits the ground and whether it rolls inward or outward. This provides data on affected posture, movement, pain levels, how much arch support is needed, and what type to wear to help prevent back pain. Once the analysis is complete, it will guide you on what to look for, such as what level of arch support, heel height, or material is best for you.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive, cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, practical strength training, and complete conditioning. We focus on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our programs are natural and use the body’s ability to achieve specific measured goals rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.


Benefits of Using Custom Foot Orthotics


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Centers for Disease Control and Prevention. (2019). Back, lower limb, and upper limb pain among U.S. adults, 2019. Retrieved from www.cdc.gov/nchs/products/databriefs/db415.htm

Harvard Health Publishing. (2014). Posture and back health. Harvard Health Education. www.health.harvard.edu/pain/posture-and-back-health

American Academy of Podiatric Sports Medicine. Ayne Furman, D. F., AAPSM. (2024). How do I know when it is time to replace my athletic shoes?

Glycogen: Fa'amumuina le Tino ma le Fai'ai

Glycogen: Fa'amumuina le Tino ma le Fai'ai

Mo tagata taʻitoʻatasi o loʻo faʻamalositino, malosi, ma faʻamalositino, pe mafai e le iloa pe faʻafefea ona fesoasoani le glycogen i le toe faʻaleleia o toleniga?

Glycogen: Fa'amumuina le Tino ma le Fai'ai

Glikogen

A manaʻomia e le tino le malosi, e toso mai i luga o ana faleoloa glycogen. O mea'ai e maualalo-carbohydrate, ketogenic ma fa'amalositino malosi e fa'aumatia ai faleoloa glycogen, ma fa'atupuina ai le ga'o o le tino mo le malosi. O le Glycogen e maua mai i ga'o ga'o i mea'ai a le tagata ma e fa'aaogaina e fa'amalosia ai le fai'ai, gaioiga fa'aletino, ma isi gaioiga fa'aletino. O molelaula e faia mai le kulukose e tele lava ina teuina i totonu o le ate ma maso. O le a le mea e 'ai, fa'afia, ma le maualuga o le gaioiga e a'afia ai le teuina ma le fa'aogaina e le tino o le glycogen. Toe fa'afo'isia le glycogen pe a mae'a fa'agaioiga fa'aletino po'o le galue o se vaega taua o le toe fa'aleleia. E mafai e le tino ona vave faʻaosoina le glycogen mai nei nofoaga e teu ai pe a manaʻomia le suauu. Ole 'ai ia lava mea'ai ga'o e ausia ai sini ole soifua maloloina ma le maualuga ole gaioiga e taua mo le manuia.

O le a

  • O le kulukose po'o le suka e teuina e le tino.
  • E teuina i totonu o le ate ma maso.
  • O le puna muamua ma le mana'omia ole malosi ole tino.
  • E sau mai carbohydrate i mea'ai ma meainu.
  • E faia mai le tele o molela'au kulukose feso'ota'i.

Gaosiga ma Teuga

O le tele o ga'o ga'o 'ai e liua i le kulukose, lea e avea ma puna malosi o le tino. Ae peita'i, a le mana'omia e le tino le fa'asusuina, o le kulukose mole o le kulukose e avea ma filifili feso'ota'i o le valu i le 12 kulukose iunite, ma fai ai se mole mole glycogen.

Fa'agasologa Fa'aoso

  • O le taumafaina o se mea'ai e maua ai le carbohydrate o le a siitia ai le maualuga o le kulukose o le toto e tali atu ai.
  • O le faateleina o le kulukose e faailoa atu ai le pancreas e gaosia ai le inisalini, o se hormone e fesoasoani i sela o le tino e ave le kulukose mai le toto mo le malosi po o le teuina.
  • O le fa'againa o le inisalini e mafua ai le ate ma maso maso e maua ai se enzyme e ta'ua o le glycogen synthase, lea e feso'ota'i fa'atasi ai filifili kulukose.
  • A lava le kulukose ma le inisalini, e mafai ona tuʻuina atu mole mole glycogen i le ate, maso, ma sela gaʻo mo le teuina.

Talu ai o le tele o le glycogen e maua i maso ma ate, o le aofaʻi o loʻo teuina i totonu o nei sela e eseese e faʻatatau i le maualuga o gaioiga, pe fia le malosi e mu i le malologa, ma meaʻai e 'ai. O maso e faʻaaoga muamua le glycogen o loʻo teuina i totonu maso, ae o le glycogen o loʻo teuina i totonu o le ate e tufatufa atu i le tino atoa, aemaise lava i le faiʻai ma le vaʻa.

Fa'aaogāina o le Tino

E liua e le tino le kulukose i le glycogen e ala i se gaioiga e taʻua o le glycogenesis. I le taimi o lenei faagasologa, o enzymes eseese e fesoasoani i le tino e talepe i lalo glycogen i glycogenolysis ina ia mafai e le tino ona faʻaaogaina. O lo'o iai le aofa'i o le kulukose o le toto ua sauni e alu i so'o se taimi. E pa'ū fo'i le maualuga ole inisalini pe a amata ona pa'ū le maualuga, a le o le le 'ai po'o le mu o le kulukose a'o fa'amalositino. A tupu lenei mea, o le enzyme e taʻua o le glycogen phosphorylase e amata ona talepeina le glycogen e tuʻuina atu i le tino le kulukose. O le kulukose mai le ate glycogen e avea ma malosiaga muamua o le tino. O taimi pu'upu'u o le malosi e fa'aaoga ai le glycogen, pe i taimi o si'isi'i po'o si'i mamafa. (Bob Murray, Christine Rosenbloom, 2018) O se vaiinu a'o le'i faia toleniga e tele le carbohydrate e mafai ona maua ai le malosi e fa'amalositino umi ai ma toe vave fa'aleleia. E tatau i tagata taʻitoʻatasi ona 'ai se meaʻai pe a maeʻa le toleniga ma le paleni paleni o gaʻo e faʻatumu ai faleoloa glycogen. E fa'aaoga fo'i e le fai'ai le kulukose mo le malosi, ma le 20 i le 25% o le glycogen e alu e fa'aola ai le fai'ai. (Manu S. Goyal, Marcus E. Raichle, 2018) E mafai ona tupu le vaivai o le mafaufau po'o le puao o le fai'ai pe a le lava le ga'o ga'o. Pe a faʻaumatia faleoloa glycogen e ala i faʻamalositino poʻo le le lava o gaʻo, e mafai e le tino ona lagona le vaivai ma le paie ma atonu e maua ai lagona ma le moe. (Hugh S. Winwood-Smith, Craig E. Franklin 2, Craig R. White, 2017)

meaʻai

O a mea'ai e 'ai ma le tele o gaioiga fa'aletino e fa'aaafia ai fo'i le gaosiga o le glycogen. O a'afiaga e mafai ona ogaoga pe a mulimulita'ia se mea'ai e maualalo le ga'o, lea e fa'afuase'i ai ona fa'atapula'aina mea'ai ga'o, o le puna muamua lea o le fa'atupuina o le kulukose.

Lelavai ma Fai'ai puao

  • O le taimi muamua e amata ai se meaai maualalo-carbo, e mafai ona matua faʻaumatia faleoloa glycogen a le tino ma e ono maua e tagata taʻitoʻatasi faʻailoga e pei o le vaivai ma le puao o le faiʻai. (Kristen E. D'Anci et al., 2009)
  • O fa'ailoga e amata ona mou atu pe a toe fetuuna'i le tino ma fa'afouina ana faleoloa glycogen.

Vai mamafa

  • So'o se aofa'i o le pa'u mamafa e mafai ona tutusa le a'afiaga i faleoloa glycogen.
  • I le taimi muamua, e mafai e tagata taʻitoʻatasi ona paʻu vave i le mamafa.
  • I le aluga o taimi, o le mamafa e mafai ona maualuga ma atonu e faʻateleina.

O le mea na tupu e mafua ona o le glycogen composition, o le vai foi. O le fa'aitiitia vave o le glycogen i le amataga o mea'ai e fa'aoso ai le pa'u o le mamafa o le vai. I le aluga o taimi, e faʻafouina faleoloa glycogen, ma toe foʻi mai le mamafa o le vai. A tupu lenei mea, o le pa'u o le mamafa e mafai ona pa'u po'o le maualuga. E mafai ona fa'aauau pea le pa'u o ga'o e ui lava i le a'afiaga i luga ole laiga pu'upu'u.

Faamalositino

Afai e faia se faʻamalositino mamafa masani, o loʻo i ai taʻiala e fesoasoani e aloese ai mai le faʻaitiitia o le faʻatinoga atonu e fesoasoani:

Carbo-loading

  • O nisi tagata ta'aalo latou te taumafaina le tele o ga'o ga'o a'o le'i faigaluega pe tauva.
  • O isi carbohydrates e maua ai le tele o suauu.
  • O le metotia ua le fiafia ona e mafai ona oʻo atu ai i le mamafa o le vai ma faʻafitauli faʻamaʻi.

Glucose Gels

  • O gels malosi o lo'o iai le glycogen e mafai ona 'ai muamua pe a mana'omia i le taimi o se fa'alavelave e fa'ateleina ai le kulukose o le toto.
  • Mo se faʻataʻitaʻiga, o le lamu malosi o ni faʻaopoopoga aoga mo tagata tamoʻe e fesoasoani e faʻateleina le faʻatinoga i taimi o taʻaloga umi.

Mea'ai Ketogenic Low-Carb

  • O le taumafaina o se mea'ai e maualuga le ga'o ma le maualalo o ga'o ga'o e mafai ona tu'u ai le tino i se tulaga keto- adaptative.
  • I lenei tulaga, ua amata ona maua e le tino le ga'o teuina mo le malosi ma fa'aitiitia le fa'alagolago i le kulukose mo le suauu.

I le Injury Medical Chiropractic and Functional Medicine Clinic, o loʻo faʻaogaina e le matou auʻaunaga se auala tuʻufaʻatasia e fausia ai fuafuaga faʻapitoa mo le tausiga o tagata taʻitoʻatasi, e masani ona aofia ai Faʻafomaʻi Faʻatonu, Acupuncture, Electro-Acupuncture, ma Taʻaloga Taʻaloga mataupu faavae. O la matou sini o le toe faʻaleleia o le soifua maloloina ma le gaioiga i le tino.


Mea'ai Tau Ta'aloga ma Ta'aloga Taumafa


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Murray, B., & Rosenbloom, C. (2018). Faʻavae o le glycogen metabolism mo faiaoga ma tagata taʻalo. Iloiloga o taumafa, 76(4), 243–259. doi.org/10.1093/nutrit/nuy001

Goyal, MS, & Raichle, ME (2018). Kulukose Manaoga o le Atina'e Fai'ai o le Tagata. Journal of pediatric gastroenterology and nutrition, 66 Suppl 3(Suppl 3), S46–S49. doi.org/10.1097/MPG.0000000000001875

Winwood-Smith, HS, Franklin, CE, & White, CR (2017). O mea'ai maualalo-carbohydrate e fa'aosoina ai le fa'afitauli o le metabolic: o se faiga e mafai ona fa'asaoina ai le glycogen. American journal of physiology. Fa'atonu, tu'ufa'atasi ma fa'atusatusaga o le tino, 313(4), R347–R356. doi.org/10.1152/ajpregu.00067.2017

D'Anci, KE, Watts, KL, Kanarek, RB, & Taylor, HA (2009). Mea'ai e fa'aitiitia le ga'o-carbohydrate. Aafiaga i le mafaufau ma lagona. Mana'ai, 52(1), 96–103. doi.org/10.1016/j.appet.2008.08.009

Faʻaleleia le Soifua Maloloina o le Intervertebral Disc: Taʻiala mo le manuia

Faʻaleleia le Soifua Maloloina o le Intervertebral Disc: Taʻiala mo le manuia

For individuals who are dealing with back pain and problems, could knowing how to improve and maintain intervertebral disc health help alleviate symptoms?

Faʻaleleia le Soifua Maloloina o le Intervertebral Disc: Taʻiala mo le manuia

Intervertebral Disc Health

The spinal column comprises 24 movable bones and 33 bones called vertebrae. The vertebral bones are stacked on top of each other. The intervertebral disc is the cushioning substance between the adjacent bones. (Dartmouth. 2008)

Bones

The vertebral bones are small and round in an area called the vertebral body. In the back is a bony ring from which protrusions extend and arches and pathways are formed. Each structure has one or more purposes and includes: (Waxenbaum JA, Reddy V, Williams C, et al., 2023)

  • Stabilizing the spine.
  • Providing a space for the connective tissue and back muscles to attach.
  • Providing a tunnel for the spinal cord to pass through cleanly.
  • Providing a space where nerves exit and branch out to all areas of the body.

faatulagaga

The intervertebral disc is the cushioning that sits between the vertebrae. The design of the spine allows it to move in various directions:

  • Flexion or bending
  • Extension or arching
  • Tilting and rotation or twisting.

Powerful forces act upon and influence the spinal column to produce these movements. The intervertebral disc absorbs shock during movement and protects the vertebrae and spinal cord from injury and/or trauma.

Malosiaga

On the outside, strong woven fiber tissues form an area called the annulus fibrosis. The annulus fibrosis contains and protects the softer gel substance in the center, the nucleus pulposus. (Y.S. Nosikova et al., 2012) The nucleus pulposis provides shock absorption, flexibility, and pliability, especially under pressure during spinal movement.

Mechanics

The nucleus pulposus is a soft gel substance located in the center of the disc that allows elasticity and flexibility under stress forces to absorb compression. (Nedresky D, Reddy V, Singh G. 2024) The swivel action alters the tilt and rotation of the vertebra above and below, buffering the effects of spinal motion. The discs swivel in response to the direction the spine moves. The nucleus pulposus is made mostly of water, which moves in and out through small pores, acting as byways between the vertebra and disc bone. Body positions that load the spine, like sitting and standing, push the water out of the disc. Lying down on the back or in a supine position facilitates water restoration into the disc. As the body ages, the discs lose water/faʻamago, leading to disc degeneration. The intervertebral disc has no blood supply, which means that for a disc to receive necessary nutrition and for waste removal, it must rely on water circulation to stay healthy.

tausiga

Some ways of maintaining intervertebral disc health include:

  • Paying attention to posture.
  • Changing positions frequently throughout the day.
  • Exercising and moving around.
  • Applying correct body mechanics to physical activities.
  • Sleeping on a supportive mattress.
  • Fainu le tele o vai.
  • Taumafa maloloina.
  • Faatumauina o se maloloina maloloina.
  • Drinking alcohol in moderation.
  • Taofi le ulaula tapaa.

At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual’s ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractic team, care plans, and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Acupuncture, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.


Beyond the Surface: Understanding the Effects of Personal Injury


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Dartmouth Ronan O’Rahilly, MD. (2008). Basic Human Anatomy. Chapter 39: The vertebral column. In D. Rand Swenson, MD, PhD (Ed.), BASIC HUMAN ANATOMY A Regional Study of Human Structure. W.B. Saunders. humananatomy.host.dartmouth.edu/BHA/public_html/part_7/chapter_39.html

Waxenbaum, J. A., Reddy, V., Williams, C., & Futterman, B. (2024). Anatomy, Back, Lumbar Vertebrae. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29083618

Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. doi.org/10.1111/j.1469-7580.2012.01537.x

Nedresky D, Reddy V, Singh G. (2024). Anatomy, Back, Nucleus Pulposus. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30570994

Le Taua o le Fa'amālōlōina Mea'ai Pe a Ma'ea Mea'ai Oona

Le Taua o le Fa'amālōlōina Mea'ai Pe a Ma'ea Mea'ai Oona

Can knowing which foods to eat help individuals recovering from food poisoning restore gut health?

Le Taua o le Fa'amālōlōina Mea'ai Pe a Ma'ea Mea'ai Oona

Food Poisoning and Restoring Gut Health

Food poisoning can be life-threatening. Fortunately, most cases are mild and short-lived and last only a few hours to a few days (Centres for Control Control and Prevention, 2024). But even mild cases can wreak havoc on the gut, causing nausea, vomiting, and diarrhea. Researchers have found that bacterial infections, like food poisoning, can cause changes in gut bacteria. (Clara Belzer et al., 2014) Eating foods that promote gut healing after food poisoning may help the body recover and feel better faster.

Meaʻai e 'Ai

After food poisoning symptoms have resolved, one may feel that returning to the usual diet is fine. However, the gut has endured quite an experience, and even though acute symptoms have subsided, individuals may still benefit from foods and drinks that are easier on the stomach. Recommended foods and beverages after food poisoning include: (National Institute of Diabetes and Digestive and Kidney Diseases. 2019)

  • Gatorade
  • Pedialytes
  • vai
  • Lauti lauti
  • Soa moa
  • sieli
  • Apu
  • Fusi
  • Toga
  • Rice
  • Oatmeal
  • faʻi
  • Potatoes

Hydration after food poisoning is crucial. Individuals should add other nutritious and hydrating foods, like chicken noodle soup, which helps because of its nutrients and fluid content. The diarrhea and vomiting that accompany the illness can leave the body severely dehydrated. Rehydrating beverages help the body replace lost electrolytes and sodium. Once the body is rehydrated and can hold down bland foods, slowly introduce foods from a regular diet. When resuming the usual diet after rehydration, eating small meals frequently, every three to four hours, is recommended instead of eating a large breakfast, lunch, and dinner meal daily. (Andi L. Shane et al., 2017) When choosing Gatorade or Pedialyte, remember that Gatorade is a sports-rehydrating drink with more sugar, which could irritate an inflamed stomach. Pedialyte is designed for rehydrating during and after illness and has less sugar, making it a better option. (Ronald J Maughan et al., 2016)

When Food Poisoning Is Active Foods To Avoid

During food poisoning, individuals typically do not feel like eating at all. However, to avoid worsening the illness, Individuals are recommended to avoid the following while actively ill (Ohio State University. 2019)

  • Caffeinated drinks and alcohol can further dehydrate.
  • Greasy foods and high-fiber foods are hard to digest.
  • Foods and beverages high in sugar can cause the body to produce high glucose levels and weaken the immune system. (Navid Shomali et al., 2021)

Recovery Time and Resuming Regular Diet

Food poisoning doesn’t last long, and most uncomplicated cases are resolved within a few hours or days. (Centres for Control Control and Prevention, 2024) Symptoms depend on the type of bacteria. Individuals may become ill within minutes of consuming contaminated food up to two weeks later. For example, Staphylococcus aureus bacteria generally cause symptoms almost immediately. On the other hand, listeria may take up to a couple of weeks to cause symptoms. (Centres for Control Control and Prevention, 2024) Individuals can resume their usual diet once symptoms are gone, the body is thoroughly hydrated and can hold down bland foods. (Andi L. Shane et al., 2017)

Recommended Gut Foods Post Stomach Virus

Gut-healthy foods can help restore the gut microbiome or all the living microorganisms in the digestive system. A healthy gut microbiome is essential for immune system functioning. (Emanuele Rinninella et al., 2019) Stomach viruses can disrupt the balance of gut bacteria. (Chanel A. Mosby et al., 2022) Eating certain foods may help restore the gut balance. Prebiotics, or indigestible plant fibers, can help break down in the small intestines and allow the beneficial bacteria to grow. Prebiotic foods include: (Dorna Davani-Davari et al., 2019)

  • Peni
  • Aluga
  • tamato
  • lauliliʻi
  • Peas
  • Meli
  • Miliki
  • faʻi
  • Wheat, barley, rye
  • Ata
  • Soya
  • Vaeluaga

In addition, probiotics, which are live bacteria, may help increase the number of healthy bacteria in the gut. Probiotic foods include: (Harvard Medical School, 2023)

  • Pickles
  • Areto palu
  • Kombucha
  • Sauerkraut
  • Yogurt
  • Miso
  • kefir
  • Kimchi
  • Tempe

Probiotics can also be taken as a supplement and come in tablets, capsules, powders, and liquids. Because they contain live bacteria, they need to be refrigerated. Healthcare providers sometimes recommend taking probiotics when recovering from a stomach infection. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018) Individuals should consult their healthcare provider to see whether this option is safe and healthy.

At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.


Aʻoaʻoina e Uiga i Suiga Meaʻai


mau faasino

Centers for Disease Control and Prevention. (2024). Food poisoning symptoms. Retrieved from www.cdc.gov/foodsafety/symptoms.html

Belzer, C., Gerber, G. K., Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh, C., & Bry, L. (2014). Dynamics of the microbiota in response to host infection. PloS one, 9(7), e95534. doi.org/10.1371/journal.pone.0095534

National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Eating, diet, & nutrition for food poisoning. Retrieved from www.niddk.nih.gov/health-information/digestive-diseases/food-poisoning/eating-diet-nutrition

Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K., Langley, J. M., Wanke, C., Warren, C. A., Cheng, A. C., Cantey, J., & Pickering, L. K. (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(12), e45–e80. doi.org/10.1093/cid/cix669

Maughan, R. J., Watson, P., Cordery, P. A., Walsh, N. P., Oliver, S. J., Dolci, A., Rodriguez-Sanchez, N., & Galloway, S. D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. The American journal of clinical nutrition, 103(3), 717–723. doi.org/10.3945/ajcn.115.114769

Ohio State University. Kacie Vavrek, M., RD, CSSD Ohio State University. (2019). Foods to avoid when you have the flu. health.osu.edu/wellness/exercise-and-nutrition/foods-to-avoid-with-flu

Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and applied biochemistry, 68(2), 404–410. doi.org/10.1002/bab.1938

Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7(1), 14. doi.org/10.3390/microorganisms7010014

Mosby, C. A., Bhar, S., Phillips, M. B., Edelmann, M. J., & Jones, M. K. (2022). Interaction with mammalian enteric viruses alters outer membrane vesicle production and content by commensal bacteria. Journal of extracellular vesicles, 11(1), e12172. doi.org/10.1002/jev2.12172

Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. doi.org/10.3390/foods8030092

Harvard Medical School. (2023). How to get more probiotics. www.health.harvard.edu/staying-healthy/how-to-get-more-probiotics

National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Treatment of viral gastroenteritis. Retrieved from www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis/treatment

Le Ta'iala A'oa'o ile Su'ega Su'ega: Mafua'aga ma Fofo

Le Ta'iala A'oa'o ile Su'ega Su'ega: Mafua'aga ma Fofo

Can knowing treatment options for a dislocated hip help individuals expedite rehabilitation and recovery?

Le Ta'iala A'oa'o ile Su'ega Su'ega: Mafua'aga ma Fofo

Dislocated Hip

A dislocated hip is an uncommon injury but can happen due to trauma or following hip replacement surgery. It usually occurs after severe trauma, including motor vehicle collisions, falls, and sometimes sports injuries. (Caylyne Arnold et al., 2017) A dislocated hip can also occur after hip replacement surgery. Other injuries like ligament tears, cartilage damage, and bone fractures can occur alongside the dislocation. Most hip dislocations are treated with a joint reduction procedure that resets the ball into the socket. It is usually done with sedation or general anesthesia. Rehabilitation takes time and could be a few months before full recovery. Physical therapy can help restore motion and strength in the hip.

O le a?

If the hip is only partially dislocated, it’s called a hip subluxation. When this happens, the hip joint head only partially emerges from the socket. A dislocated hip is when the head or ball of the joint shifts or pops out of the socket. Because an artificial hip differs from a normal hip joint, the risk of dislocation increases after joint replacement. A study found that around 2% of individuals who undergo total hip replacement will experience hip dislocation within a year, with the cumulative risk increasing by approximately 1% over five years. (Jens Dargel et al., 2014) However, new technological prosthetics and surgical techniques are making this less common.

Hip Anatomy

  • The hip ball-and-socket joint is called the femoroacetabular joint.
  • The socket is called the acetabulum.
  • The ball is called the femoral head.

The bony anatomy and strong ligaments, muscles, and tendons help to create a stable joint. Significant force must be applied to the joint for a hip dislocation to occur. Some individuals report feeling a snapping sensation of the hip. This usually is not a hip dislocation but indicates a different disorder known as snapping hip syndrome. (Paul Walker et al., 2021)

Posterior Hip Dislocation

  • Around 90% of hip dislocations are posterior.
  • In this type, the ball is pushed backward from the socket.
  • Posterior dislocations can result in injuries or irritation to the sciatic nerve. (R Cornwall, T E Radomisli 2000)

Anterior Hip Dislocation

  • Anterior dislocations are less common.
  • In this type of injury, the ball is pushed out of the socket.

Hip Subluxation

  • A hip subluxation occurs when the hip joint ball starts to come out of the socket partially.
  • Also known as a partial dislocation, it can turn into a fully dislocated hip joint if not allowed to heal properly.

O auga

Faʻailoga e mafai ona aofia ai:

  • The leg is in an abnormal position.
  • Difficulty moving.
  • Severe hip pain.
  • Le mafai ona onosaia le mamafa.
  • Mechanical lower back pain can create confusion when making a proper diagnosis.
  • With a posterior dislocation, the knee and foot will be rotated towards the body’s midline.
  • An anterior dislocation will rotate the knee and foot away from the midline. (American Academy of Orthopedic Surgeons. 2021)

Mafuaaga

A dislocation can cause damage to the structures that hold the ball in the socket and can include:

  • Cartilage damage to the joint –
  • Tears in the labrum and ligaments.
  • Fractures of the bone at the joint.
  • Injury to the vessels that supply blood can later lead to avascular necrosis or osteonecrosis of the hip. (Patrick Kellam, Robert F. Ostrum 2016)
  • A hip dislocation increases the risk of developing joint arthritis following the injury and can raise the risk of needing a hip replacement later in life. (Hsuan-Hsiao Ma et al., 2020)

Developmental Dislocation of the Hip

  • Some children are born with developmental dislocation of the hip or DDH.
  • Children with DDH have hip joints that did not form correctly during development.
  • This causes a loose fit in the socket.
  • In some cases, the hip joint is completely dislocated.
  • In others, it’s prone to becoming dislocated.
  • In milder cases, the joint is loose but not prone to becoming dislocated. (American Academy of Orthopedic Surgeons. 2022)

faiga

Joint reduction is the most common way to treat a dislocated hip. The procedure repositions the ball back into the socket and is usually done with sedation or under general anesthesia. Repositioning a hip requires significant force.  A hip dislocation is considered an emergency, and reduction should be performed immediately after the dislocation to prevent permanent complications and invasive treatment. (Caylyne Arnold et al., 2017)

  • Once the ball is back in the socket, the healthcare provider will look for bone, cartilage, and ligament injuries.
  • Depending on what the healthcare provider finds, further treatment may be necessary.
  • Fractured or broken bones may need to be repaired to keep the ball within the socket.
  • Damaged cartilage may have to be removed.

Togafitiga

Surgery could be necessary to return the joint to its normal position. Hip arthroscopy can minimize the invasiveness of certain procedures. A surgeon inserts a microscopic camera into the hip joint to help the surgeon repair the injury using instruments inserted through other small incisions.

Hip replacement surgery replaces the ball and socket, a common and successful orthopedic surgical procedure. This surgery may be performed for various reasons, including trauma or arthritis, as it is common to develop early arthritis of the hip after this type of trauma. This is why many who have a dislocation ultimately need hip replacement surgery. As a major surgical procedure, it is not without risks. Possible complications include:

  • Faʻafitauli
  • Aseptic loosening (the loosening of the joint without infection)
  • Taofi suilapalapa

le toe faaleleia

Recovering from a hip dislocation is a long process. Individuals will need to walk with crutches or other devices early in recovery. Physical therapy will improve the range of motion and strengthen the muscles around the hip. Recovery time will depend on whether other injuries, such as fractures or tears, are present. If the hip joint was reduced and there were no other injuries, it may take six to ten weeks to recover to the point where weight can be placed on the leg. It could be between two and three months for a full recovery. Keeping weight off the leg is important until the surgeon or physical therapist gives the all-clear. Injury Medical Chiropractic and Functional Medicine Clinic will work with an individual’s primary healthcare provider and other surgeons or specialists to develop an optimal personalized treatment plan.


Chiropractic Solutions for Osteoarthritis


mau faasino

Arnold, C., Fayos, Z., Bruner, D., Arnold, D., Gupta, N., & Nusbaum, J. (2017). Managing dislocations of the hip, knee, and ankle in the emergency department [digest]. Emergency medicine practice, 19(12 Suppl Points & Pearls), 1–2.

Dargel, J., Oppermann, J., Brüggemann, G. P., & Eysel, P. (2014). Dislocation following total hip replacement. Deutsches Arzteblatt international, 111(51-52), 884–890. doi.org/10.3238/arztebl.2014.0884

Walker, P., Ellis, E., Scofield, J., Kongchum, T., Sherman, WF, & Kaye, AD (2021). Snapping Hip Syndrome: Ose Fa'afouga Atoa. Iloiloga fa'apitoa, 13(2), 25088. doi.org/10.52965/001c.25088

Cornwall, R., & Radomisli, T. E. (2000). Nerve injury in traumatic dislocation of the hip. Clinical orthopaedics and related research, (377), 84–91. doi.org/10.1097/00003086-200008000-00012

American Academy of Orthopaedic Surgeons. (2021). Hip dislocation. orthoinfo.aaos.org/en/diseases–conditions/hip-dislocation

Kellam, P., & Ostrum, R. F. (2016). Systematic Review and Meta-Analysis of Avascular Necrosis and Posttraumatic Arthritis After Traumatic Hip Dislocation. Journal of orthopaedic trauma, 30(1), 10–16. doi.org/10.1097/BOT.0000000000000419

Ma, H. H., Huang, C. C., Pai, F. Y., Chang, M. C., Chen, W. M., & Huang, T. F. (2020). Long-term results in the patients with traumatic hip fracture-dislocation: Important prognostic factors. Journal of the Chinese Medical Association : JCMA, 83(7), 686–689. doi.org/10.1097/JCMA.0000000000000366

American Academy of Orthopaedic Surgeons. (2022). Developmental dislocation (dysplasia) of the hip (DDH). orthoinfo.aaos.org/en/diseases–conditions/developmental-dislocation-dysplasia-of-the-hip-ddh/

Su'esu'e Aafiaga Fa'amalologa ole Acupressure

Su'esu'e Aafiaga Fa'amalologa ole Acupressure

Can incorporating acupressure provide effective relief and benefits for individuals looking to try natural treatments for common health ailments?

Su'esu'e Aafiaga Fa'amalologa ole Acupressure

Acupressure

Acupressure is a type of complementary medicine that is rising in popularity due to its simplicity and accessibility. It can assist in treating various diseases and conditions. (Piyush Mehta et al., 2016) Anyone can learn it, and no special equipment is required. It is an effective and safe therapeutic option with no known side effects. (Youngmi Cho et al., 2021) It is a cost-effective intervention similar to acupuncture. (Lukas Israel et al., 2021)

O le a?

The concept of acupressure activates acupoints or pressure points across meridians or channels connected to various organs to balance energy and promote health. Practitioners believe that the quality or state of a person’s energy determines their health. (Piyush Mehta et al., 2016) Acupressure is the stimulation of acupoints using either the fingers or a tool. Massage techniques like Amma, Shiatsu, Tui Na, and Thai massage incorporate acupressure in their treatments and follow the same energy channels as acupuncture.

Le Ala e Galue ai

Acupressure works similarly to acupuncture. The Gate Control Theory theorizes that pleasure impulses reach the brain four times faster than pain impulses. Continuous pleasurable impulses close the neural gates and block slower messages, like pain. According to this theory, acupressure improves the pain perception threshold. (Piyush Mehta et al., 2016) Stimulating acupoints activates functional responses, like releasing hormones. These hormones serve various functions, physical, like regulating organ function, and mental, like regulating emotions, and releasing them can help improve health and well-being. (Piyush Mehta et al., 2016)

  • Acupressure is a simple and effective intervention that can be self or professionally administered.
  • Acupoints are activated in the elbows, fingers, feet, knuckles, palms, or thumbs.
  • Though acupressure doesn’t require specialized tools, they are available for convenience.
  • Some practitioners used Bian stones to activate acupoints.
  • Modern tools can assist with activating acupoints. (Piyush Mehta et al., 2016)
  • Pressing the acupoints is adequate, and inaccuracies are unlikely to cause harm or injury. (Youngmi Cho et al., 2021)

O nisi o meafaigaluega available include: (Piyush Mehta et al., 2016)

  • Spinal device
  • totigilima
  • Device for fingers
  • Peni
  • liʻo
  • seevae
  • Laupapa laupapa
  • Device for ear
  • Fusi

faamanuiaga

Acupressure is often used alongside modern medicine, as it treats common or coexisting symptoms, such as anxiety or stress. Some of the conditions for which acupressure may be effective include.

Stress and Fatigue Reduction

Stress and fatigue are common but often arise alongside other ailments or conditions if persistent or severe, anxiety and fatigue can significantly affect quality of life by reducing an individual’s ability to participate in daily activities. In a study looking at shift work nurses who experience stress and fatigue from the intensity of their work, acupressure significantly reduced their symptoms. (Youngmi Cho et al., 2021) In studies with breast cancer survivors, acupressure was also used to decrease fatigue levels and was shown to be an effective and low-cost option for managing persistent fatigue alongside standard care for breast cancer. (Suzanna Maria Zick et al., 2018) (Suzanna M Zick et al., 2016)

Can Help With Anxiety and Depression

Depression and anxiety can be part of a disorder or exist on their own. Acupressure may help alleviate some of the anxiety and depression that arise as part of a condition or ailment. In the shift work nurses study, acupressure helped decrease anxiety levels. (Youngmi Cho et al., 2021) In other studies, acupressure reduced anxiety scores and improved depressive symptoms in individuals with mild to moderate symptoms. (Elizabeth Monson et al., 2019) (Jingxia Lin et al., 2022) (Suzanna Maria Zick et al., 2018)

Faaitiitia tiga

Individuals experience physical pain for a variety of reasons. Pain can come from temporary taaloga injuries, work, sudden awkward movements, and/or chronic illness. Acupressure can effectively reduce pain as a complementary therapy. (Elizabeth Monson et al., 2019) In a study, athletes who had a musculoskeletal sports injury reported decreased pain intensity after three minutes of acupressure therapy. (Aleksandra K Mącznik et al., 2017) In another study, breast cancer survivors showed significant improvements with acupressure. (Suzanna Maria Zick et al., 2018)

Manava Toomaga

Nausea and vomiting are conditions that are common for those who are pregnant or undergoing chemotherapy. It also can be a medication side effect or arise with migraine or indigestion. There is evidence that acupressure may be effective in alleviating symptoms. Some researchers believe a particular type of acupressure known as auricular acupressure is the most effective for treating chemotherapy-induced nausea and vomiting alongside standard treatment. (Jing-Yu Tan et al., 2022) However, further research is needed to determine whether this is a viable, ongoing option for treating nausea and vomiting. (Heather Greenlee et al., 2017)

Moe lelei

Acupressure can be an effective and low-cost option for managing breast cancer symptoms. One study found relaxing acupressure techniques improved sleep quality and quality of life in breast cancer survivors. Additionally, researchers note that relaxing acupressure is more effective for improving sleep and quality of life than stimulating acupressure. (Suzanna M Zick et al., 2016)

Allergy Reduction

Allergic rhinitis is inflammation caused by an allergic reaction. Previous trials have found that acupressure could improve overall health by reducing seasonal allergic rhinitis symptoms and the need for allergy medication. (Lukas Israel et al., 2021) Researchers also noted that individuals are likely to adhere to self-applied acupressure therapy as a form of self-massage. (Lukas Israel et al., 2021)

Always consult a healthcare provider before starting acupressure treatments, especially if you have any pre-existing health conditions. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. Flexibility, mobility, and agility programs are tailored for all age groups and disabilities. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.


Enhance Performance with Functional Foot Orthotics


mau faasino

Mehta, P., Dhapte, V., Kadam, S., & Dhapte, V. (2016). Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments. Journal of traditional and complementary medicine, 7(2), 251–263. doi.org/10.1016/j.jtcme.2016.06.004

Cho, Y., Joo, J. M., Kim, S., & Sok, S. (2021). Effects of Meridian Acupressure on Stress, Fatigue, Anxiety, and Self-Efficacy of Shiftwork Nurses in South Korea. International journal of environmental research and public health, 18(8), 4199. doi.org/10.3390/ijerph18084199

Israel, L., Rotter, G., Förster-Ruhrmann, U., Hummelsberger, J., Nögel, R., Michalsen, A., Tissen-Diabaté, T., Binting, S., Reinhold, T., Ortiz, M., & Brinkhaus, B. (2021). Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chinese medicine, 16(1), 137. doi.org/10.1186/s13020-021-00536-w

Zick, S. M., Sen, A., Hassett, A. L., Schrepf, A., Wyatt, G. K., Murphy, S. L., Arnedt, J. T., & Harris, R. E. (2018). Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer Survivors. JNCI cancer spectrum, 2(4), pky064. doi.org/10.1093/jncics/pky064

Zick, S. M., Sen, A., Wyatt, G. K., Murphy, S. L., Arnedt, J. T., & Harris, R. E. (2016). Investigation of 2 Types of Self-administered Acupressure for Persistent Cancer-Related Fatigue in Breast Cancer Survivors: A Randomized Clinical Trial. JAMA oncology, 2(11), 1470–1476. doi.org/10.1001/jamaoncol.2016.1867

Monson, E., Arney, D., Benham, B., Bird, R., Elias, E., Linden, K., McCord, K., Miller, C., Miller, T., Ritter, L., & Waggy, D. (2019). Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores. Journal of alternative and complementary medicine (New York, N.Y.), 25(5), 517–521. doi.org/10.1089/acm.2018.0422

Lin, J., Chen, T., He, J., Chung, R. C., Ma, H., & Tsang, H. (2022). Impacts of acupressure treatment on depression: A systematic review and meta-analysis. World journal of psychiatry, 12(1), 169–186. doi.org/10.5498/wjp.v12.i1.169

Mącznik, A. K., Schneiders, A. G., Athens, J., & Sullivan, S. J. (2017). Does Acupressure Hit the Mark? A Three-Arm Randomized Placebo-Controlled Trial of Acupressure for Pain and Anxiety Relief in Athletes With Acute Musculoskeletal Sports Injuries. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 27(4), 338–343. doi.org/10.1097/JSM.0000000000000378

Tan, J. Y., Molassiotis, A., Suen, L. K. P., Liu, J., Wang, T., & Huang, H. R. (2022). Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial. BMC complementary medicine and therapies, 22(1), 87. doi.org/10.1186/s12906-022-03543-y

Greenlee, H., DuPont-Reyes, M. J., Balneaves, L. G., Carlson, L. E., Cohen, M. R., Deng, G., Johnson, J. A., Mumber, M., Seely, D., Zick, S. M., Boyce, L. M., & Tripathy, D. (2017). Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: a cancer journal for clinicians, 67(3), 194–232. doi.org/10.3322/caac.21397

Ho, K. K., Kwok, A. W., Chau, W. W., Xia, S. M., Wang, Y. L., & Cheng, J. C. (2021). A randomized controlled trial on the effect of focal thermal therapy at acupressure points treating osteoarthritis of the knee. Journal of orthopaedic surgery and research, 16(1), 282. doi.org/10.1186/s13018-021-02398-2