Tag Archives: exercising

After an injury, GAIT OR RUNNING RETRAINING HAS TO BE DONE

If you’re suffering from a running injury or a sports related injury, doing your rehab exercise might not be enough. When I’m treating patients with a running or sports related injury, I always look at the patient’s running form or the activity that caused there pain to see what is causing their injury. Squatting with weight on your back is another common cause of pain I see. After the exam and watching the patient movement during the sport of their choice, then the teaching starts. I try to improve there the patient form hopefully preventing the injury again.

There is no reason to return to your activity strong but still performing the activity poorly.

There is a study below that confirms this approach.

If you have an injury or are concerned about your form please contact the office! We can help you reach your peak performance.

Mirror Gait Retraining for the Treatment of Patellofemoral Pain in Female Runners Authors: Willy RW, Scholz JP & Davis IS Author’s Affiliations: Division of Physical Therapy, Ohio University, Athens Ohio; Department of Physical Therapy, University of Delaware, Newark, DE; Spalding National Running Centre, Harvard Medical School, MA, USA. Publication Information: Clinical Biomechanics 2012; 27(10):1045-51

Leg exercise is critical to brain and nervous system health

New research shows that using the legs, particularly in weight-bearing exercise, sends signals to the brain that are vital for the production of healthy neural cells. The groundbreaking study fundamentally alters brain and nervous system medicine — giving doctors new clues as to why patients with motor neuron disease, multiple sclerosis, spinal muscular atrophy and other neurological diseases often rapidly decline when their movement becomes limited.

Bottom line here folks: you have to move, you have to load, especially if you have a neurologic disorder and especially if you are declining in age. At the very least, throw some lunges or body weight squats into your day. Walk the stairs, don’t ride the elevator. Move. Lift. Strain.

https://www.sciencedaily.com/releases/2018/05/180523080214.htm

Can Stronger Hips Help Knee Arthritis?

Knee Osteoarthritis

Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? The short answer is YES.

Anyone with Osteoarthritis in their knees knows how it can limit their life. For one example walking could become difficult and painful.

A study from the British journal of sports medicine has found strengthening the hips muscle can help with knee osteoarthritis.

Walking improved after the addition of hip strengthening to quadriceps strengthening in people with knee Osteoarthritis. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function

simple but effective hip exercise

Key points

  • Land-based exercise reduces pain and improves function in people with knee osteoarthritis (KOA) over the short to medium term.
  • People with KOA have weakness in hip abduction is (7%–24% weaker than control patients).
  • Hip abduction strength is positively related to function in people with KOA.
  • Hip strengthening is beneficial compared with non-exercise interventions in people with KOA.

Hislop AC, Collins NJ, Tucker K, Deasy M, Semciw AI. Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis. British Journal of Sports Medicine. 2020 Mar 1;54(5):263-71. Link

Being Over weight Can Increase Risk For Tendon Issues

Tendinopathy

“Obesity is associated with a higher risk of tendinopathy, tendon tear and rupture, and complications after tendon surgery than non-obesity.”

  • Medial epicondylitis: odds ratio (OR) 1.9 
  • Achilles tendinopathy: OR 3.81 
  • Patellar tendinopathy: OR 1.10 
  • Plantar fasciitis: OR 2.97 
  • Rotator cuff tendinopathy: OR 1.25 
  • Rotator cuff tear: OR 2.35 
  • Rotator cuff rupture leading to tendon surgery  OR 3.13 – 3.51 
Photo by Joenomias–2512814

Macchi M, Spezia M, Elli S, Schiaffini G, Chisari E. Obesity Increases the Risk of Tendinopathy, Tendon Tear and Rupture, and Postoperative Complications: A Systematic Review of Clinical Studies. A Publication of The Association of Bone and Joint Surgeons®| CORR®. 2020 Apr 14. Link

Running Injury Prevention Strategies Part 2

Having good running form is another way to prevent running injuries. There are many nuances to running form. We’ll discuss the big three. They are Cadence, Posture and Foot placement.

Cadence (Stride Length)

The amateur runner may not put much thought into their running beyond putting one foot in front of the other, however, if you are finding yourself with consistent pain in your shins or recurring lower leg injuries the way you run may be playing a role. New research has demonstrated that when you take a longer stride as you run, the ground reaction force on your legs will be increased. This increased force can lead to more injuries and micro traumas that can lead to chronic injuries and discomfort.

With Cadence think quick feet. A faster stride will reduce the amount of time you spend on the ground and decreased ground-reaction force. This reduces the impact on your body gets hitting the ground.

 If you think that this may be affecting your ability to run pain-free, try taking some shorter runs and actively think about taking shorter steps while running. Your legs will have to move faster to maintain the same pace as before. It will take some time to retrain your brain to alter your running pattern, but with some regular training, you should be able to make the transition.

Photo by sasint–3639875
See how long her stride is? If the foot is landing far in front of you, your cadence is most likely low.

Posture

Good posture will help you run with less pain and prevent injuries. Basically good posture will create good running posture. Your head should be over your ribcage and your rib cage should be over you pelvis and pelvis over your feet. This posture will let you run using less energy. If your posture is good it will be easier to fill your lungs with air. Next is to engage your core and build midline stabilization.

Foot Placement

Stand with your feet shoulder width apart. This is a very stable position. Now stand with one foot in front (heel to toe). That’s harder right? Standing this way or running this way takes a lot of balance and energy. We’ll call this cross over gait. When we run we should land with our foot under our knee and our knee under our hip. This will support your center of mass better. Think leaning tower of Pisa, the top is not over the bottom making it unstable.

Photo by John-Silver–3202135
The base would be the foot and the hip would be the top.
Take a look at this runner. His foot is on the midline of the body. The leg is not stacked The hip is not stacked over knee or foot. Can you see the pelvis dropping on the left side as well?

Photo by Andrea Piacquadio
Can you see the cross over gait? The foot is midline, the hip once again is not stacked over the knee and foot. Look at her stomach muscles. Can you see the twisting? Here’s an example of the core not being engage and lack of midline stabilization.

If you are new to running or experienced and need help we are here! Please call the office to set up an appointment.

Running Injury Prevention Strategies Part 1

Running has become one of the most common forms of physical activity in today’s society. It can be a community building activity, a personal challenge and most importantly a great work out. It is a sport that everyone can participate in; all you need is a good pair of shoes and a little motivation. That being said running can be extremely hard on your body, especially when you are just starting.  We are finding that injuries among runners are very common. From shin splints to rolled ankles, no one is immune from getting hurt; however, here are some tips to keep you healthy and on pace.

Photo by RUN 4 FFWPU

Do not do too much, too fast

            When runners are just starting and begin to make progress, they tend to push their limits. Although this is a great way to challenge yourself, it is important that you understand your body has a threshold that when exceeded results in injury. Your mileage should be tracked on both a daily and weekly basis. If you have never done much long-distance running, then your weekly mileage should begin quite low. It is important that as you improve your mileage increases gradually. A consensus among the running community is the rule of 10%. Do not increase your mileage by any more than 10% on a week to week basis. For many runners and new runners specifically, 10% may even be too much of a jump. This is why when preparing for a distance race, whether it is a 10k, half marathon or a marathon it is recommended you start as early as possible. Could you train and complete a half marathon in 6 weeks? Maybe, but the toll it could take on your body and the injury risk you are exposing yourself to are likely not worth it. A recent study showed that runners who only increased their mileage by 3% a week had a much higher rate of success in their upcoming races than runners who ramped up their mileage quicker.

            So how do you know where to start? First, start with walking. If you can walk an hour a day with out any injury you may start running. As a new runner, start with short runs and accumulate miles over the week. It is important to understand how far you have been running, so I recommend using an app on your phone such as “Map My Run” to help track each run. Personally I have a Garmin GPS watch , that links to Garmin connect. Garmin connect is an app. Most GPS watches can be linked to an app.

Photo by Mateusz Dach

Do not run through significant pain

As runners, we all understand some discomfort is a part of the sport. Your legs and feet will likely be sore after a long run; however, if you begin to notice significant pain or discomfort while running consider taking a break. Breaks are one of the hardest things to convince a runner of doing, but it could save you from more severe injury. Aside from the odd rolled ankle, very few running injuries are acute and traumatic. Far more commonly runners ignore the pain and “tough it out” when they begin to feel discomfort.

This can result in a cumulative injury cycle. What is that you might ask? It means if you continue to stress an injury by running, you will continue to make it worse and it can become a much more significant issue. Sometimes all it takes is an extra day off when symptoms are minor to allow your body to recover. This is important because if you have an injury, it is very common for your body to adapt by altering your gait (running pattern).

This may lead you to be less efficient, develop bad habits or in a worst-case scenario cause an injury elsewhere in your body. Remember, everything is connected, so if you are running with a limp the biomechanical stresses will be placed on a different part of your body. Give your body a chance to recover and if you think that an injury is nagging have a medical professional look at it. It is much more beneficial to have an injury taken care with a couple of sessions of treatment rather than letting it persist and having to deal with it when it is much more serious, and your recovery time is extended.

Photo by RUN 4 FFWPU

Call the office if you’re having pain. Do not tough it out! It could only get worse. We work with a lot of athletes and help them return to activity. Athletes looking to prevent injuries or perform better see us.

Managing Neck Pain and Headaches Part 2

Neck pain and headaches are a very common issue in our society, and understanding the causes and prevention of them will go a long way to leading a healthy and pain free life. In this educational summary, we discuss some of the most common conditions we see in our office. Below we will discuss the following neck-related pain conditions.

  1. Upper Crossed Syndrome
  2. Headaches
  3. Neck Sprain/Strain
  4. Disc Pain
  5. Cervical Radiculopathy
  6. TMJ Dysfunction

Neck Strain/Sprains

Cervical strains and sprains are some of the most common injuries sustained to the cervical spine. A cervical strain is when an injury occurs to the muscles of the cervical spine. A sprain, on the other hand, is an injury to the ligaments or joints; both, however, have similar pain and symptom patterns. Patients suffering from this diagnosis often have pain when attempting to move the head and neck, especially at end ranges of motion. Another symptom that sufferers’ may experience is frequent headaches, which may not seem directly evident to the patient that the source of the headaches may be caused by their cervical strain or sprain.

The main physical causes of this condition are:

  • Automobile accidents
  • Whiplash
  • Contact sports injuries
  • Repetitive overuse injury
  • Prolonged poor posture

Obviously some of the time these injuries are impossible to avoid, such as traumatic automobile accidents and whiplash injuries. At this point there are no steps for prevention and your next course of action is to seek treatment, usually with ice in the days immediately following the injury as well as therapeutic modalities such as interferential electrical stimulation, Active Release Technique, and massage.

In cases where the injury stems from a problem related to overuse, poor posture or improper exercise, there are steps that can be taken to help avoid these injuries from happening. Proper instruction on ergonomics in the workplace, fixing posture and instilling healthy habits, as well as receiving the proper knowledge in exercising can help build a better foundation for a healthy spine for life.

Neck Disc Pain

Discogenic Pain Syndrome is a condition that results from soft tissue damage and associated irritation of the fibers of intervertebral discs. Intervertebral discs are cushions found between each vertebra of the spine that work as shock absorbers to protect the vertebrae by helping dissipate the forces applied to the spine and to help facilitate movement. The cervical discs are found between the vertebrae of the spine in the area we think of like the neck. Intervertebral discs consist of an outer annulus fibrous, made up of tough, fibrous connective tissue, which surrounds a gel-like center called the nucleus pulposus. The outer third of the annulus fibrous is innervated by nerves and contain pain and mechanical receptors which mediate pain transmission from structural damage to the intervertebral discs or indirectly through chemically mediated inflammation.

Cervical disc pain can arise from a variety of reasons, whether by injury or a degenerative condition. In most cases, the condition can be treated to allow the person to continue his/hers active lifestyle.

Potential causes of Cervical Discogenic Pain Syndrome

  • Direct trauma – falls, motor vehicle accident, whiplash, sports injury
  • Overuse, fatigue, repetitive microtrauma – over hours, days, months of the same position
  • Postural – can be either an intrinsic postural problem (e.g. loss of cervical curvature) or an extrinsic postural problem (e.g. prolonged stressful position, protruded head posture).
  • Sudden unguarded movement.
  • Degenerative disc disease.

Symptoms of Cervical Discogenic Pain Syndrome

The symptoms will vary depending on whether the condition is caused by a herniated disc or by a degenerative disc. With a herniated disc, some people will not experience pain in the neck but will have radiating pain, tingling, and numbness down the arm or around the shoulder blade due to pressure put on the nerve root. Discogenic pain due to an injury can result in immediate pain or pain shortly after the injury. Headaches (usually cervicogenic) can also result from cervical disc pain.

Treatment of Cervical Discogenic Pain Syndrome

Treatment for cervical discogenic pain will depend on the clinical presentation. Conservative treatment can successfully manage many cervical disc herniations. Initial treatment will focus on controlling pain and inflammation. Once pain and inflammation have decreased, early rehabilitation will help prevent chronic pain and disability. This will consist of osseous manipulation, soft tissue therapy, activity as tolerated, and pain-free range of motion exercises. Late rehabilitation will be administered as the condition improves and will include stabilization exercises, patient education, and postural training. Education in proper training, biomechanics, and a home exercise program will help strengthen the spine and decreases the likelihood of future injury. If you fail to respond to conservative treatment, or in cases of severe pain, diagnostic imaging (x-ray, MRI) will be warranted, and an orthopedic consult may be necessary.

Dr. Steve is always here to help your neck pain and headaches. If you are suffering from either please set up an appointment to start the healing process!

How to Stop Muscle Wasting

The best way to stop muscle wasting is to lift weight and do some form of cardio vascular conditioning.

Which weight lifting exercise are best? They are called complex movements.

Here a list:

  • Squatting
  • Dead lift ( hip hinge)
  • Pushing movements( push ups and bench press)
  • Pulling movements( Lat Pull down and Pull ups)

Now you don’t have to be muscle bound to do these movements. However, doing these movements with some weight would help keep the muscle you have and possibly add some muscle.

Now you might be thinking you can’t squat because you may have bad knees or a bad back. Squatting is basically getting out of a chair. So start with that, getting out of chair 10 time is a row. Doing that a few times a day is a great way to start! You will not believe how sore you can get from this routine. Once you have done this for a few weeks move on to some thing harder. Goblet squats are the safest. Start with a light weight and just keep adding weight. It’s that easy.

Working from home?

Are you working from home because of the Corona virus?

It’s a great feeling to accomplish work from the comfort of your kitchen table. While working from home can help avoid some of the headaches of a regular workplace — such as long commutes and inflexible work hours — it can still cause its own discomforts, especially if you’re using a laptop.

Imagine slaving over a hot keyboard from your kitchen table, doing work while sprawled on your bed, or hunched over a coffee table from your couch. It’s no wonder that  injuries and pain can happen just as commonly at home as it does from the workplace!

Working at home should be a comfortable, productive experience. With our training, we can identify habits and poor work setups that could cause you pain while you work at home. We help you so you can remain productive anywhere… even in your pajamas.

What do you imagine when you think of an office workspace? Many people envision designated cubicles, desks, coworkers, the proverbial water cooler, and computer setups with keyboards and mouses.

However, when you think of a home workspace, you may picture something else entirely: a kitchen table, or sitting in the familiar indentation on the couch or being flopped on a bed with a laptop and notebook nearby.

It is important to consider that working from the comfort of your home is not always comfortable. When we ask our patients that work from home to describe their workstation setup, very few tell us that they have a separate home office with a desk. 

Good ergonomics isn’t limited to the usual 9-to-5 workday. The same practices that can help avoid aches and pains at the workplace can be applied to your home office, too!

The most important tip that we can offer when working from home is to have a designated workstation with a comfortable office chair. Having the right setup will allow you to work productively, pain-free, and more easily while you work in the comfort of your home.

If so, I want to take a moment to look at your home office space.

If your workspace involves hunching over the coffee table with a too-low laptop and a sprawl of spreadsheets everywhere, then we need to talk!

Working at home should be comfortable, flexible, and beneficial to your time and energy. It shouldn’t be a source of pain.

If you’re not sure how to design a good office space within the comfort of your home, don’t worry. We can help.  Give our office a call, and our trained doctors of chiropractic can help review your workspace and make recommendations that work best for you and the space you have!

Laptops are fantastic for their lightweight portability. Unfortunately, the features that make laptops so versatile can also cause other issues!  Keyboard spacing, screen size and positioning, and pointing devices are all poorly designed when it comes to laptop computers, creating issues in your neck, upper back, lower back, and even hands. 

Furthermore, it is nearly impossible to have good posture when using a keyboard fixed to a laptop! Because the keyboard and the monitor are attached to each other, it is a challenge to sit ideally when working.

One tip is to have an adjustable office chair to get the proper body positioning and height when sitting, especially if your laptop rests on a surface that is not height adjustable. Put the laptop on a stand, so the screen remains at eye level to reduce neck strain, and if possible, use an attachable keyboard instead to give your wrists and forearms more support while typing.

For more tips, give our office a call.  We are well-versed in helping you prevent injuries, whether it’s at the workplace, your home office, or your local productive coffee shop!

What Pillow should I get?

Are you Sleeping on the Right Pillow?

Determining the right pillow is a personal choice that a person will make every so often. When it comes to thinking about sleep equipment, most people solely focus on the mattress. The mattress is one of the most important sleep equipment you will buy, but when it comes to sleep quality pillows are just as important. How you lay your head when sleeping plays a huge role in determining the type of support you need. Pillows not only impact the quality of sleep but can prevent any neck discomfort.

Why Does Your Pillow Matter?

A proper pillow will facilitate a good night’s sleep without you waking up at night or waking up with pain or a stiff neck. Having the wrong pillow over time can exacerbate unnecessary neck pain. There are a few factors that go into making a guide for yourself to determine the proper pillow for you.

Back Sleeper:

Sleeping on your back might appear to be comfy, but will highlight the underlying issue of snoring if you have a pillow that allows your head to sink. As you lay your head back, gravity will push the tongue back and block your throat. A better alternative will be a pillow that offers height, neck support and keeps the throat at a comfortable level.

Side Sleeper:

One of the most common positions to sleep in is on the side. You will need more support to keep the neck at a neutral angle.

Stomach Sleeper:

Sleeping on your stomach might be comfortable for a few nights, but after a while can become taxing on your back and neck. However, having the right pillow can negate some of these issues. A firm/plump pillow will force your neck into an odd angle that might lead to some discomfort. A better alternative would be a softer option.

When Is It Time To Replace Your Pillow?

On average, a pillow should be replaced every 18 months. The old age rule “ you pay for what you get” applies to this transaction. A higher quality pillow will last longer than an inexpensive option. Something you can do to your pillow to see if you need a new one is, take it out of the pillowcase to see if there are any stains or fold it in half and see if the pillow stays folded. If either of these are a yes then it is time to replace your pillow.