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00:00:00to help you. This
00:00:04From an unexpected cramp to weakness that makes it difficult to walk
00:00:08or lift objects, muscle disorders can affect
00:00:11our daily lives in different ways. Today we are going to learn
00:00:15about the symptoms, causes, and medical attention for
00:00:19so-called muscle disorders. I am Ana Luisa Guerrero and I welcome you
00:00:22to Consulta Directa.
00:00:24Let's begin.
00:00:40And on this occasion, I am very pleased to welcome the
00:00:44specialists who are with us. From the
00:00:47General Hospital of Mexico Eduardo Leciaga, we have Dr. Gabriel
00:00:51Medrano Ramírez, who is head of the rheumatology
00:00:54service. Welcome, thank you very much, doctor, thank you for the invitation.
00:00:58We also welcome licensed Dafne García Pérez, who is
00:01:02don't know, the benches, as I was telling you, a rehabilitator from the Physical Medicine and Rehabilitation
00:01:04Service. Thank you very much for joining us. Thank
00:01:08cramps are, of course, one of the you very much. Well, today we are going to talk about an interesting
00:01:11topic. At some point in our lives, we have all experienced some muscular
00:01:15discomfort, and I don't know, the specialists will tell us now if with the passage
00:01:19of time these discomforts can
00:01:21increase and even incapacitate us in our daily lives,
00:01:25so well, this topic will give us a lot to talk about,
00:01:29so let's start with
00:01:32people, which can of muscle or tendon a segment we have prepared and then we'll come back to
00:01:33discuss it.
00:01:36Walking, climbing stairs, carrying groceries, or
00:01:40simply getting out of bed are movements we make
00:01:43almost without thinking, until pain,
00:01:47stiffness, weakness, or difficulty moving appears.
00:01:50A cramp that wakes you up during the night, a muscle that contracts,
00:01:54these can be occasional discomforts, but when they
00:01:57become frequent or interfere with daily life, everyday
00:02:02such as extensor tendon injuries or tasks can become a real challenge. Muscle
00:02:04disorders can manifest in different
00:02:07ways: pain, stiffness, weakness,
00:02:11tremors, spasms, or
00:02:13brief pause and upon returning we are going to start involuntary contractions. Among them are muscle
00:02:16cramps that cause sudden and painful
00:02:19contractions, tetany that can cause contractions and
00:02:22stiffness, dystonias, which generate involuntary
00:02:26movements and abnormal postures, and restless
00:02:29legs syndrome, characterized by a
00:02:32difficult-to-control urge to move the
00:02:35doubt, the risk of not complying with legs, primarily during rest. The
00:02:38causes are diverse: physical exertion,
00:02:41dehydration, some medications, or mineral
00:02:45imbalances can trigger certain discomforts.
00:02:48Others may be related to metabolic or neurological
00:02:52diseases. Additionally, in Mexico,
00:02:55musculoskeletal disorders are among the main causes of
00:02:58principales causas de...
00:03:00important it is to be aware of disability. That's why you shouldn't get used to living with
00:03:03pain, weakness, or involuntary movements.
00:03:07Timely medical evaluation can help identify their
00:03:10origin and find the appropriate
00:03:14age. Precisely that's what treatment.
00:03:17Well, we generally saw what the main muscle discomforts are,
00:03:21these conditions that
00:03:24can appear at any
00:03:28indicating to us when time and are related to our physical activity, to our daily life. And precisely, as
00:03:33Possess elementary notions of I said in the introduction, I would like, doctor, to discuss how frequent
00:03:37it is that these appear as we age, or what
00:03:40are the circumstances associated with their
00:03:44permanence? Very good. Well, talking about musculoskeletal
00:03:48problems is talking about an endless number of diseases. In fact,
00:03:51it is practically a highly prevalent entity.
00:03:55It is not specifically inherent to elderly people; in fact, there can
00:03:58be very young people with manifestations or musculoskeletal
00:04:02problems. However, evidently, the age
00:04:05group of patients also influences it, perhaps to
00:04:09have more risk, precisely because their
00:04:12muscles, if they are not
00:04:15is immobility. That is trained, are weakened muscles. They are people who are perhaps using
00:04:19polypharmacy, diuretic use, in short,
00:04:22other entities that can practically affect the
00:04:26locomotor system,
00:04:28which occasionally, at the end of the day, manifests as pain.
00:04:32I speak of the musculoskeletal term because this
00:04:35influences or includes many structures, from muscles,
00:04:39ligaments, tendons, the periarticular issues,
00:04:42etc., and in different parts or groups of the
00:04:46body that can be affected. Without a doubt, well,
00:04:49we've all talked about cramps, and maybe we have them
00:04:52identified, but what are the main conditions that occur, Dafne,
00:04:56in these sets, as the doctor said, musculoskeletal,
00:04:59and how frequently
00:05:03do they appear? Well, as the doctor mentioned, it's not necessarily
00:05:07avoid the death of what in adulthood; it can be from youth. Nowadays, there
00:05:10are countless diseases that entail
00:05:13this, no, pain, a muscle spasm, it can be
00:05:16just a contracture or something due to posture, that we end up
00:05:20hurting our spine; it also appears there. It can
00:05:24be, as the doctor says,
00:05:27hereditary, it can be rheumatic, it can be from the
00:05:30system, it's always a whole, but in the area of
00:05:34rehabilitation, the way we approach it, we do the
00:05:37consultation and determine a rehabilitative diagnosis. Of
00:05:40course, we rely on the specialties and from
00:05:44there they direct the patient to the approach, depending on the
00:05:48pathology, we can use tank therapy, well,
00:05:52hydrotherapy, we can use
00:05:54electrotherapy depending on the
00:05:57origin, either due to a pathology or a mechanopostural
00:06:00injury. It can be those two, of course. Well,
00:06:04uh, we said at the beginning, any of us could
00:06:07be exposed to this type of injury. I would like
00:06:11us to be able to identify them, doctor, because
00:06:14precisely, to know
00:06:18that it could be a discomfort that we might be feeling
00:06:22on a daily basis and that gradually worsens or that appears suddenly.
00:06:26How do we identify them
00:06:29in order to treat them? All right, well,
00:06:32first, talking about these musculoskeletal diseases
00:06:36is talking about everything and nothing because there are countless
00:06:39diseases that can cause some manifestation
00:06:44affliction. How to identify them is very important. The
00:06:48interview to be able to identify where the
00:06:51clinical manifestation comes from. It is relevant to mention
00:06:54that the specific approach for this type of disease does not
00:06:58only concern one area; in fact, it is an
00:07:01entity that may require a multidisciplinary intervention
00:07:05such as neurologists, rheumatologists,
00:07:07orthopedists, rehabilitators. From
00:07:11here, then, it is very important to consider that
00:07:14these muscle alterations can be
00:07:17caused by mechanical injuries, they can be caused by
00:07:21metabolic diseases such
00:07:24caused by electrolyte deficiency, they can be
00:07:27caused by inflammatory autoimmune
00:07:30processes, potentially they can also be caused
00:07:33by neurological problems that secondarily affect the
00:07:37muscle, so in general, what I wanted to encompass
00:07:40right now is that talking about a
00:07:42musculoskeletal disease can be an endless number of
00:07:46diseases that it is our job as doctors to identify
00:07:50in order to classify it, and by classifying
00:07:53I mean naming it, for example, inflammatory myopathies, for example,
00:07:57fibromyalgia, for example, mitochondrial
00:07:59myopathies, uh, complex regional
00:08:03painful syndromes that have several subclassifications,
00:08:07uh, or a simple muscle tear injury,
00:08:10low back pain that can have different origins.
00:08:14Yes, the range is wide, and it all depends, it's very wide. In fact,
00:08:18pain is practically one of the main reasons for
00:08:21medical attention requests from all people, at any
00:08:27I wanted to focus on. When
00:08:30the patient starts to feel pain, because that's the first, I imagine, the first symptom.
00:08:34But what are other symptoms, Dafne, that could be
00:08:37related and that could be
00:08:41it's time to seek rehabilitation? In this case, as the
00:08:44doctor says, pain primarily. From there, that pain will make my
00:08:47daily activities difficult, even bathing. It gets to the point where the
00:08:51pain in my shoulders is so great that I can't even lift my arm.
00:08:55I can't walk. My pain becomes so great that it will
00:08:59make it difficult for me to get dressed, bathe, which are daily
00:09:02living activities, even work. At that moment, I think it's already a very,
00:09:06very great pain. We should have already gone. Don't wait for a
00:09:10level 10 pain. The moment I have a level two or three pain, something that
00:09:14prevents me from doing an activity, is the time to be able to
00:09:17consult the specialist. It's
00:09:20an important topic because, at the end of the day, not all
00:09:23patients go immediately to the specialist, right?
00:09:27So, the medical evaluation comes later,
00:09:31when several weeks have passed
00:09:34and they have already
00:09:37used painkillers.
00:09:40Well, in these cases, when so much time is allowed to pass, what
00:09:44are the main consequences, Dr. Gabriel? I think that to be able
00:09:48to answer this question, I will take a very
00:09:51particular example of an entity. I will talk about
00:09:54idiopathic inflammatory myopathies, of which there are several, which is an
00:09:58autoimmune muscle disease,
00:10:00which evidently affects what is the striated muscle, which is the muscle with which
00:10:04we move. If a
00:10:07patient comes to receive early attention, they will have a good
00:10:10prognosis because we will work on the
00:10:14appropriate treatment. This practically helps to
00:10:19are the muscle cells. However,
00:10:22in clinical experience, we have had patients
00:10:26who have arrived many months or even years after
00:10:29having this disease, and practically when they come to
00:10:32us, they already have a great muscle injury that
00:10:36is practically irreversible. With this, what I want to
00:10:39comment or clarify is that early attention is very important.
00:10:43If a patient has any muscle
00:10:47discomfort, muscle weakness,
00:10:51they should go to their primary care doctors,
00:10:54family doctors, general practitioners, or perhaps internal medicine if
00:10:58they need hospitalization. Later, according
00:11:01to the physical examination and medical history that
00:11:05is taken, they will consult the specialty that
00:11:09will practically follow up on this, which will be neurology,
00:11:12rheumatology, orthopedics, and
00:11:15as I have commented on several occasions, very closely
00:11:18with the rehabilitation service, since the rehabilitation
00:11:21service will help in a non-medical way, but concomitantly
00:11:25within another group of specific treatments to
00:11:29help improve the patient's functionality.
00:11:32Yes, it is relevant what you say, Dr.
00:11:35Gabriel, that precisely when a medical evaluation is carried out,
00:11:39of course, according to the diagnosis that is made,
00:11:43a series of recommendations are given, most people use, well, of course, the
00:11:47medications and these things that they prescribe. How frequent is it,
00:11:50Dafne, I would like you to answer, that when they are sent to
00:11:53rehabilitation, they may attend the first few consultations
00:11:56and then they start suspending the treatment
00:12:00precisely because they feel that the discomfort has decreased. How
00:12:03frequent is this? Yes, it is frequent. In fact, when
00:12:07they come for a consultation, they are always told the number of sessions.
00:12:10There are people who may have five, 10, 15, well, five sessions or 10
00:12:14sessions. For people who only have a certain level, as
00:12:18the doctor says, if we divide the pathologies and according to the
00:12:21need, that's how they will take their rehabilitation.
00:12:25There are those who say, "I have level five pain, I feel perfect after
00:12:28three sessions, I won't go again," but that patient
00:12:31will come back in the future, and the pain they had will no longer be level
00:12:35three. We'll be at a high pain level, and there will already be
00:12:38effects, for example, in the trapezius, now it will
00:12:41go to the back, now it will go to the spine. Skeletal compensations
00:12:45begin to occur to maintain that pain, but yes, it is
00:12:48frequent. There are people who adhere and truly have the
00:12:51commitment to the therapy and finish their sessions.
00:12:55They go to their consultation and sometimes they come back again. Yes, without a
00:13:00them, well, it can further affect the health condition of
00:13:04each of the patients. We are going to take a short break, and when we return, we will
00:13:07begin to answer the questions you send us regarding
00:13:11our topic of the day. We are talking about muscle disorders,
00:13:15so I invite you to write to us. Our contact information is appearing on screen.
00:13:19Here are our specialists to answer each
00:13:22of your questions. We'll be right back.
00:13:27Direct consultation,
00:13:29continued.
00:13:33This Monday at 12:30 p.m. on "How do I do it,"
00:13:37let's learn everything we need to deal with any emergency
00:13:41with first aid. First aid are therapeutic
00:13:44procedures that we can apply to victims of
00:13:48an accident or sudden illness. They are intended
00:13:51to preserve the patient's life, not to improve their
00:13:54health condition.
00:13:58medical techniques on channel
00:14:0114. This ingenious young woman has arrived in the
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00:14:09Where are you going? Don't be scared, buddy, I'm here to work.
00:14:11Here,
00:14:17well, my love, I'm leaving. I hope she doesn't come. She's already
00:14:21here. Cinema 14 presents
00:14:24Paquita's packages, Monday 2:25
00:14:28p.m. Hi, I'm Maria Teresa Priego. This
00:14:32week on Abiertamente, I invite you to talk with anthropologist
00:14:36Ed Hernández, author of the book La Esperanza. You
00:14:39talk about poverty and racialization. When I talk
00:14:42about racialized territories, it means that you have regions in the
00:14:46mountains of Guerrero, for example, where there are no hospitals, where prosecutor's offices are
00:14:50very far away, and in these same regions you have
00:14:53a very strong concentration of violence.
00:14:57Abiertamente, Monday, 5:00
00:15:00p.m.
00:15:07Don't miss this week's "Te Emigrante" which will feature a talk with the
00:15:11Mexican ambassador to the United States, Roberto
00:15:14Latzeri, with whom we will discuss how the protection of
00:15:18Mexicans in the United States has been, the legal route, but also
00:15:21what the advances are and where Mexico stands in the
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00:15:26it!
00:15:33Direct consultation,
00:15:34we return.
00:15:39We're back! Thank you for tuning into Channel
00:15:4214. We are in this space, Consulta Directa, which
00:15:46is designed for you, so I invite you to send
00:15:50us all your suggestions regarding health topics that you
00:15:54would like us to address. Our contact information is appearing on screen.
00:15:57That's where we receive each of your proposals. You can
00:16:01find us at @ canal14mx, on
00:16:03Facebook, X, and YouTube, or
00:16:07send us a WhatsApp message at 5513
00:16:1056 60 25. This is the
00:16:13space where we listen to each of your proposals.
00:16:16And precisely because we love to know
00:16:19what you think, what your main concerns are, we
00:16:23went out to the city streets and asked our audience
00:16:27what their main questions are regarding our
00:16:31topic of the day: muscle disorders. Let's listen to some of
00:16:34them so we can answer them. Hello, my
00:16:37name is Geraldín and my question for the experts is what can
00:16:41cause a cramp? Yes,
00:16:45most common discomforts
00:16:48that occur most frequently among the population.
00:16:51I would like, Dr. Gabriel, to precisely
00:16:55describe what a cramp is and what its causes are. Well,
00:16:58okay, I think cramps are perhaps the most frequently described
00:17:02alterations in the population, perhaps more
00:17:05frequent in elderly
00:17:09be caused by muscle atrophy, by
00:17:13disuse, and when patients suddenly start using a limb again,
00:17:17by temperature changes, electrolyte deficiency in patients
00:17:20who are chronic users of diuretics,
00:17:24for example. So this practically causes a muscle
00:17:27spasm that generates pain. It's really not
00:17:30serious but it is highly annoying. So
00:17:33here it is very important: patient education, practically
00:17:37questioning what factors have led to
00:17:41the development of cramps, and sometimes when they are very frequent,
00:17:45yes, sending them to rehabilitation so that they practically help them establish a
00:17:49therapy and reduce the frequency of these if they don't have
00:17:52electrolyte deficiencies,
00:17:56for example, that we as doctors can
00:18:00control. Yes, well, they are common and very frequent, as you
00:18:03said, the causes are many, but when we talk about
00:18:06the population when they already have a health condition, I think, for example, of
00:18:10patients with diabetes who in some cases
00:18:13also experience cramps in a
00:18:16frequent manner and that can be very annoying. Yes, well, in
00:18:20diabetic people, other factors are added,
00:18:23especially in poorly managed diabetic
00:18:26people, the development of neuropathies that lead
00:18:30to generating intense pain
00:18:32on a permanent basis at the musculoskeletal
00:18:36level, but primarily caused more than anything
00:18:39by a truly neurological alteration
00:18:43called diabetic neuropathy. Okay.
00:18:46So here are certain factors that come
00:18:49together. Yes, of course. In this case, in these patients,
00:18:53I would like to know if there is a particular rehabilitation, what is the main recommendation
00:18:57you give them from the area of physiotherapy? In particular, not
00:19:00as neuropathy. We can use if there is
00:19:04a, as the doctor says, we have first the diagnosis,
00:19:08which is a neuropathy, the cause, and everything. What happens in neuropathies?
00:19:11They lose some sensitivity. We can
00:19:14work on sensitivity, we can work on textures, we can work on
00:19:18temperatures, but mainly what we see is that bad
00:19:21posture when the diabetic patient, already
00:19:24diagnosed with advanced diabetes and as the doctor says, who did not
00:19:27take care of themselves, begins to present painful postures. They do
00:19:31not move, they stop moving, they say, "I already have, I lie down, I stay
00:19:35seated." No, everything that does not move is atrophy. What do we see in
00:19:38rehabilitation? Lack of mobility, they cannot
00:19:41achieve movements, steps, walking, sitting, standing,
00:19:45difficulties,
00:19:47rather than diabetes giving it to you, it
00:19:53what we work on in these types of patients. Yes, the main recommendation for this type of
00:19:56patients, what a precise comment. Let's see another question to
00:20:00answer it. Hello, my name is April and my question for
00:20:04the experts is if some muscle disorders can be
00:20:07prevented. Yes, well, considering that the range of
00:20:11these disorders is broad, well, there will be some
00:20:14recommendation, Dr. Gabriel, precisely as a preventative
00:20:17measure. Yes, in fact, based on that question,
00:20:21which I think is a question that could
00:20:24lead to a very broad answer, it all depends on the
00:20:27pathology. For example, with autoimmune
00:20:30diseases, there is really nothing that helps
00:20:34prevent them, but it is practically about giving
00:20:37timely treatment. That's why public education is so important.
00:20:41Now, to prevent other types of musculoskeletal
00:20:44injuries, then having well-trained
00:20:47muscles, doing frequent exercise
00:20:50to have good muscle tone, would practically help reduce the
00:20:54risk of simple musculoskeletal injuries
00:20:57such as tears, tendon injuries,
00:21:01also some alterations for younger people who go to the
00:21:04gym, well, obviously having perhaps an instructor to give
00:21:08them adequate training to avoid a muscle
00:21:11injury. This is talking about musculoskeletal
00:21:15injuries, potentially traumatic ones,
00:21:19these could indeed be
00:21:21preventable. So,
00:21:25uh, I think those would be the two important answers. Of course,
00:21:29in your area of preventable, in fact, since childhood, I'll
00:21:33go further, nowadays, how you carry your backpack,
00:21:36the children in the classroom, how ergonomically
00:21:39they are seated. There is an area of rehabilitation that is part of
00:21:42ergonomics, which is responsible for verifying that all
00:21:46the furniture or the furniture that we work with. I
00:21:52in school, are suitable for children, that we plant our
00:21:55feet well, that we are not hunched over, that I sit straight, that the weight of my
00:21:59backpack is adequate so as not to generate that overload of
00:22:03weight in children. Nowadays, video games, telephones
00:22:06cause injuries at the thumb level. Yes, there are things that
00:22:10we can prevent, by improving
00:22:13posture, strengthening, exercising, having a more active
00:22:16life, this, I think that basically is how we can prevent
00:22:20it nowadays. That's right. Go ahead. There are even
00:22:23other types of diseases that are
00:22:26occupational diseases that can cause musculoskeletal
00:22:30problems that potentially some
00:22:33people would imagine that by
00:22:37working nothing would happen to them. Well,
00:22:39simply the use of the mouse, simply the use of keyboards,
00:22:42simply having screens in the wrong position can
00:22:46cause significant musculoskeletal symptoms,
00:22:52neurological injuries such as carpal tunnel syndrome or
00:22:56injuries in the cervical spine.
00:22:59So it is very important to work on workplace
00:23:01ergonomics to reduce this type of
00:23:05risks that are highly frequent in office
00:23:08workers, which we sometimes overlook. Of course, what
00:23:12the doctor says is true, we have a specialist doctor at the hospital, Dr. Óscar,
00:23:16you had him as a guest one day, who specialized in the field of
00:23:19ergonomics. And in our area, in the rehabilitation area, we have
00:23:23two hygiene programs, it's called spinal hygiene, where
00:23:26the patient is given training, they are
00:23:29taught what the correct postures are to stand up, to lie down,
00:23:33to lift objects, for housewives, how to mop,
00:23:37how to sweep, how to wring out even a rag, which can cause
00:23:41a wrist level injury, yes, well, the
00:23:45the panorama is very broad, so we are going to eh resolve each of these doubts, but how
00:23:50the posture we also have because that will allow
00:23:54us to avoid any future injury, let's see another question
00:23:58to answer, hello, my name is Leonardo Mejía and my
00:24:01question for the experts is what importance
00:24:04does hydration have for the prevention of cramps,
00:24:07well there is another question
00:24:10you also mentioned the electrolytes also this
00:24:14doctor, the way our body is, how much
00:24:17it influences that it is directly related to the... question, in
00:24:20fact, I would now give a very classic
00:24:24example, long-distance runners,
00:24:28okay, these long-distance runners require quite
00:24:31appropriate hydration and electrolytes are extremely
00:24:34important in muscle function, the deficiency of
00:24:37them in a poorly hydrated person can
00:24:40secondarily lead to the development of quite
00:24:43severe cramps, so athletes, speaking only
00:24:47of the group of these people,
00:24:51eh have an important element eh of education especially
00:24:55if they are going to dedicate themselves to this for the
00:24:58adequate consumption of liquids
00:25:00to maintain
00:25:02eh with an adequate electrolyte intake, yes
00:25:06well there eh eh the preparation of course forms an important
00:25:09part when it comes to an activity that already implies a
00:25:13wear and tear and eh well
00:25:17eh so to speak that they already dedicate themselves professionally there is already
00:25:20a, but for example, if we talk about people who dedicate themselves
00:25:23in an amateur way for pleasure, as a recreational
00:25:27activity, how important is this recommendation and if there is a
00:25:30parameter of what is the adequate or minimum
00:25:33intake of electrolytes, in the same way the answer
00:25:36would be the same, whether professional or amateur,
00:25:40practically the intake of
00:25:42liquids and the use of electrolytes is highly
00:25:46recommended, much more in amateur people because practically...
00:25:50these people could do exercises occasionally
00:25:54and would be more subject to the
00:25:58risk of musculoskeletal injuries by not doing them
00:26:01so frequently and potentially sometimes not trained
00:26:04so it is very important eh the
00:26:08evaluation by eh even
00:26:10physical therapists or groups of trainers who give them the
00:26:14precise instructions to try to minimize or reduce
00:26:17these risks, yes, without a doubt it is very frequent that cases of
00:26:21these reach rehabilitation, Dafna, well in fact the area of
00:26:24rehabilitation is also divided into a sports area, so as a sports
00:26:28rehabilitation area, yes based on the
00:26:32population we are talking about now, yes there are injuries, but
00:26:35basically due to electrolytes, the exchange, water consumption not so much,
00:26:39but due to a bad, that is, they ran and got injured and
00:26:42did not have that prevention of tearing and we have to
00:26:46treat it if not, I hope, it's only at that point that
00:26:50rehabilitation comes to address by educating the
00:26:54patient on how to take care of the joint areas,
00:26:57that if there is a discharge after a workout so that the muscle
00:27:00returns to being calm and well, hydration, recommend
00:27:04hydration, of course, well, let's see one more question to be able
00:27:07to answer it, hello, my name is Alina Ruiz and
00:27:11my question for the experts is should
00:27:14I suspect a muscle disorder
00:27:18if my baby doesn't walk at one
00:27:20year old, well that's an
00:27:24interesting question, what can we tell the doctor,
00:27:26indeed, eh, this comment is
00:27:30extremely relevant because it forces us to
00:27:33look for some type of
00:27:37disease that could potentially affect the muscle, in
00:27:41the case of if this child is very small and does not move,
00:27:44we would have to look for eh perhaps muscular dystrophies of which
00:27:48there are several and in this regard then here the interconsultation with
00:27:51neurology would be relevant because in that age group dystrophies
00:27:55is what we think of, is what we think of in a child who does not
00:27:58move, of course it is an important issue that...
00:28:02must be seen with the specialist in the first instance,
00:28:05well seen with the pediatrician and he will be in charge of
00:28:09guiding him to the area of the specialty that corresponds, we are going to make a
00:28:15answering the questions that you send us regarding our topic
00:28:19of the day, we are talking about muscular disorders, so I invite you to
00:28:22write to us, find us at @ canal14mx on
00:28:26facebook, youtube and x or send us a whatsapp message to
00:28:30551356 60:25 we'll be
00:28:33right back.
00:28:38Direct consultation,
00:28:40we continue.
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00:30:41Direct consultation,
00:30:44we return.
00:30:46We are back, thank you for tuning
00:30:51in to channel 14 and we are
00:30:55talking about muscular disorders, and before we go.
00:30:58musculares, y antes de irnos.