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Physical Therapeutics for Fibromyalgia | Central Chiropractor

Physical therapy often takes a hands-on approach, which might make you cringe if you're experiencing pain from several hypersensitive tender points. However, in managing your fibromyalgia symptoms, gentle and effective are used by physical therapy, and will most likely play a part in the recovery process.

Can physical therapy help ease fibromyalgia?
There are a variety of physical therapy techniques. Passive treatments include hydrotherapy, heat therapy, deep tissue massage, electrical muscle stimulation, and ultrasound and relax the body. Your physical therapy program will often start with passive treatments. When you feel ready, you will begin active treatments that protect against fibromyalgia pain and strengthen your body. Your physical therapist may work with you to develop a suitable strategy.

Passive Physical Therapy Treatments for Fibromyalgia
Deep Tissue Massage: Unless you're in an extreme amount of pain, deep tissue massage is an ideal fibromyalgia treatment because…

Cycling & Hip Problems: A Scientific Approach

This article forms the second part of hip problems & on the biomechanics of endurance sports and their influence with hip issues. Previously we discussed the impact of running on the joint. El Paso, TX’s scientific chiropractor, Dr. Alexander Jimenez now concentrates on the non-impact sport of cycling with very different biomechanics and stresses on the hip.


Cycling is one of the most popular sports worldwide and there are four main disciplines: track road, mountain biking and BMX. Within these there is variation in speed and distance events. The majority of both recreational cycling events and competitive cover long distances because the distinctive element makes length sustain- in line with the bike compared to most other sports. The competitive road cyclist could ride for up to 20-30 hours in an average week and play over 5000 revolutions per hour, providing an exceptionally high repetition rate (1).

Given these extensive durations of training, cyclists predominantly sustain overuse injuries, with the neck, knee and buttock/groin areas being the most prevalent (two). The hip joint is often overlooked due to its lack of harm. The reduced injury rate gives a lack of shared knowledge about how to care for these problems. The hip requires strength and freedom to get adequate cycling biomechanics to happen. Prevention plans improve performance by maintaining the body efficient and could save important time.

Biomechanics Of Cycling

Despite injury predictors’ usage, overuse injury commonly occurs. The primary culprits for this are improper bike fit for the cyclist and biomechanical preparation, and training.

To consider cycling biomechanics, let’s look at the cycling set-up. Cycling happens in the sagittal plane: in which the limbs move through extension and flexion only. There is no way to move, like rotating. Cycling is a closed-chain exercise; significance that portion of the body is fixed in position and can’t move freely. For cycling this is the toes place on the pedals and the region. The mixture of transferring at a form ensures the limb joints will have a selection of movement.

The capability is transferred into the pedals from the cyclist’s legs. The extent of this muscle operate and so the efficacy of the force produced by the cyclist is dependent on the joint angles and muscle lengths. These factors can be altered further by the speed of pedaling and the position of the cyclist’s body and chair along with handle-bar elevation (4).

The phases of the cycling action are shown in Figure 1 below.

The power phase occurs when the pedal moves from 0° (TDC) to 180° via the activation of numerous key muscle groups (see Figure 1). Here they are functioning at over their action to generate propulsion and continues until the BDC with knee extension and significant hip to complete the pedal propulsion. From 180° to 270° the hamstrings and gastrocnemius muscles keep action until the hip flexors are triggered to increase knee and hip flexion. This occurs to:

1) decrease the pedal resistance and allow muscle recovery

2) push the pedal to the rear and create lift during the retrieval

3) completely flex the leg to build muscle energy and prepare the leg for stretching to initiate the power phase for the beginning of the cycle (4).

This pattern builds power and enhances cadence. The joint effort of muscles around back and the front of the thighs is vital for co-activation and improves the energy transfer between stages whilst protecting the joints from overload. Muscle fatigue and change the efficacy of the energy and therefore the cyclist’s functionality and limb asymmetry can occur. Upon them force is going to be put as the muscles tire, causing. Since the cyclist proceeds to train in such same repetitive moves, the micro-trauma result in trauma and/or tear and eventually increases. The knee and hip joints have been brought through the entire intense of flexion to full extension and replicated extensively placing them greatly in danger of- trauma. Because the pelvis is fixed in place on the saddle, the hip muscles are additional at risk as well as the cyclist will push half of their body fat.

Factors Of Bike Set-Up For Biomechanics

Biomechanics that are efficient and effective is the initial half of the story. Possessing a bike set up that was correct is the second element in preventing harm supported and is well aligned on the bicycle for optimum power output. Factors to Take into Account in setup design include:

1. Seat height

The seat’s elevation determines the degree of hip motion. The leg muscles are accepted beyond their optimal length-tension connection, if the chair is too high and they have to work to attain force generation. The hip will be attracted. As the fisherman consequentially rocks side to side, the encompassing hip muscles will need to over- activate to restrain this and will fatigue from overuse. When the muscles are exhausted, continued cycling can cause muscle strains. This occurs if the seat is too low and deepens the hip flexion. The main muscles involved in stabilizing the thoracic during this situation would be the adductors (inner thigh) and the gluteals.

2. Seat position

The seat can be moved backwards or forwards based on the cyclist’s leg span. When it’s too far backwards, the hamstrings and gluteals become over-lengthened since the cyclist has to stretch the leg further to keep to pedal. If it is placed too far forward the hip is brought farther into extension and there is below-optimal length-tension (meaning the muscles are not able to generate enough electricity).

3. Bar reach and drop

This is the cyclist’s position because they reach out into the bars. As it depends entirely on the cyclist’s body position, it varies greatly. The place is made more aerodynamic when the cyclist can tilt their pelvis anteriorly (see Figure 2). This enables a propulsion and also reduces the strain to the hip flexor muscles.

4. Lower limb alignment

Where the hip is in accord with the ankle and the knee, each leg should follow right alignment. The legs should also be symmetrical either side of the bike to ensure equal power generation and not to overload one limb more than another (1). Limb can impact balance on the bike and slow down your speed.

Prevention Plans

This article has highlighted the importance of keeping muscle equilibrium between the anterior and posterior leg muscles, in addition to between the left and right legs. Decrease injury rates and expertise on the bike was proven to minimize, therefore complete and adequate training should be ensured by the cyclist. The significant muscle groups should be strengthened for to enhance muscle co-activation to create power and power gain.

Strengthening Exercises

Strengthening exercises should happen in a position that is close to which of the demand that is on-bike. The pelvis position is the key factor in achieving a good position. The pelvis should be anteriorly tilted; see Figure 2. This facilitates a greater place and reduces the surface area of the cyclist. To achieve anterior pelvic tilt the cyclists must have both trunk and hip flexibility(7).

These two exercises can be utilized to develop the cyclist hip and trunk flexibility:

1) Cat stretch

Arch the back upward to bend it as far as you can, tucking your head and buttocks underneath. Then do the opposite uncurl the back so the dips in the center, and lift your head and buttocks upwards. This will produce throughout the backbone in the following directions.

2) Lunge stretch

On both knees, place one knee further forward that you are in a position with the back knee on the floor. Bring the hips arch and forward the back a little to create stretch in hip.

Strengthening Exercises

All these exercises should focus on maintaining a stable pelvis, ie it should not rotate or move but instead stay with the hip bones facing forwards (except at the swimming exercise in which the hip bones will face downwards) and at precisely the same height throughout.

1) Standing kick back

Stand on one leg with the knee slightly flexed and your trunk flattened as if you were on the bicycle. Bend the other leg at knee and the hip and then press on it backward behind one. Repeat by straightening and bending the leg whilst keeping the remainder of the body.

2) Single-leg squat

Stand with the hips, knees and ankles. Bend on one knee, keeping the knee on the feet and the back straight. Rise back up. You can add to the in a twist.

3) Swimming

Begin with the shoulders right over the hips above the knees and the palms. Keeping the pelvis neutral, extend one arm out out behind you. Hold for five minutes and then go back slowly and controlled. Repeat with the opposite leg and arm.


  • Cycling is a closed-chain sport where overuse injuries are due to the motion and repeated forces. Micro-trauma is caused by overuse and contributes to muscle strain and injury.

  • Muscles and the hip joint are involved to create power, hold the cyclist and to divide forces that are equal into the right and left legs.

  • During the energy phase of cycling the hip moves to push forwards; throughout the recovery phase the hip bends to bring the pedals rearward and prepare for another phase, giving constant forces.

  • Lower limb may be minimized through strengthening the hip muscles and coaching to construct experience and mileage.

  • Preparation , correct training and bike set-up are key to injury prevention in the cyclist. These factors will also be the same for enhancing performance

1. Brukner P and Khan K (2009). Clinical Sports Medicine. 3rd ed. Australia: McGraw-Hill Professional. 69-74.

2. Int J Sports Med. 1995; 16:201-206.

3. J Am Podiatric Med Assoc. 2000;90:354-376.

4. Phy Ther in Sport. 2005 Feb;6:89-96.

5. J Sports Med and Phys Fitness. 2007;47(1):51-57.

6. J Biomechan. 1999; 32(9):899-906.

7. Phy Ther in Sport. 2007 Sep;8:22-29.

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