I recently posted a research journal that stated that after an injury patient’s gait might need to be retrained. Here is an example of a patient with a dysfunctional gait:
Take a look at this patient’s gait. Watch her left leg and then watch the right leg. The left knee tracks outward. Look at the patient’s knee. It points outward right instead of pointing forward. Look at the patient’s foot. This patient is towing off laterally and not getting into her big toe.
The second video is after treatment of adjustment to her foot, ankle and lower back, plus a week of home exercises along with some mental corrections. Patient was cued on the changes in her gait and how to improve the lower extremity function. We practiced in the office and the patient was sent home with some homework.
This is an example of how gait retraining can help improve a patient’s function. Strengthening the body is very important but strengthening dysfunctional movements will not progress the patient towards optimal.
Dorsiflexion is a important movement that occurs in the ankle. Dorsiflexion the ability for the ankle to bend upward towards your head. We need a minimum of 10 degrees to have good functioning ankle. Its common to lose this motion. Pointing our toes down is called plantar flexion. Look at this patient feet. The left ankle lost its dorsiflexion.
I want to thank the patient for lettings me use these pictures.
Loss of range of motion can be treated with with adjustments and home exercises. Look at how much better the ankle bends after an adjustment to the foot and ankle. This patient responded very well. He is young and the problem was not going for too long so he responded super well.
Patient was also given one strengthening exercise as well as a stretching to do at home to help him heal faster.
We treat ankle pain all the time here at Sikorsky Chiropractic. If you’re experiencing any pain or an injury to your ankle give the office a call!
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.
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.
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.
If you are new to running or experienced and need help we are here! Please call the office to set up an appointment.
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.
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.
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.
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.
New research published in Frontiers of Pediatrics found that children and adolescents who spend most of their time barefoot develop motor skills differently from those who habitually wear shoes. 👟 Further, they found the habitually barefoot children had noticeably better jumping and balancing skills compared to those who wore shoes habitually.
Walking barefoot not only has influences on developing proper biomechanics, but also has great influences on the brain 🧠. Walking barefoot allows for greater sensory afferentation to the brain, from the feeling of grass between their toes to balancing on pebbled sidewalks.
Try to give your young children enough time without shoes!
In this study they found that hip weakness was linked to knee pain. I treat a lot of runners that have knee pain, and most of them have weak hips.
“Women with Patellofemoral Pain Syndrome had 33% lower hip abduction peak strength. They also had significant 70% lower knee extension force steadiness and 60% lower hip abduction force steadiness than pain-free women. Evidence-based treatments aiming at improving force steadiness may be a promising addition to PFP rehabilitation programs.“
Below is a helpful exercise to strengthen your hips. As always, if you need any guidance do not hesitate to call the office!
Ferreira AS et al. Knee and Hip Isometric Force Steadiness Are Impaired in Women With Patellofemoral Pain. J Strength Cond Res. 2019 Jul 22. Link
Active rather than passive treatments are the key to recovering from “Runner’s Knee”, according to new international treatment guidelines co-authored by La Trobe University physiotherapy researcher Dr Christian Barton.
❇️ People with kneecap pain should engage in exercise-therapy, namely hip & knee strengthening
❇️ An exercise program that gradually increases activities such as running, exercise classes, sports, or walking, is the best way to prevent kneecap pain
❇️ Risk of kneecap pain can be reduced through improved leg strength, particularly the thigh muscles
❇️ Pain does not necessarily equate to knee damage
What happens if you don’t have pain or you are a casual runner that is just looking for a new pair of running shoes?
The research shows that selecting running shoes based on comfort is the best.
The best way to know if they are comfortable is by trying them on and run at least a quarter-mile. If the shoe feels good then that is the right shoe for you! That’s it, pretty easy, right? If the sneaker feels good, that’s the one to buy.
Keep it simple! Your body knows what it needs.
Below is a nice summary of shoe research.
If you missed my other posts on running shoes click here! And if you need help with shoes or running in general please give us a call!
People that come into our chiropractic clinic for treatment after lumbar disc herniation or disc bulging frequently have a history of pain which is worse in the morning and then improves after they’ve been up moving around for a bit.
Often they have some questions about what exercises and stretches they can do in the morning to make them feel better. We learned more about morning back pain in a disc – injured patient after the research of Michael Adams in the 1980s.(1,2) Adams referred to the “diurnal behavior of the disc” which mostly refers to the tendency for the discs to absorb moisture from the tissues around them overnight.
The discs soak up the fluids from the tissues around them while a person is recumbent in bed overnight. So in the morning when they wake up the outer layers of the disc are under a bit more tension, which we refer to as hydrostatic pressure.
In turn, the disc becomes a bit more plump, adding pressure to nerves and surroundingstructors.
So what should you do? Once you get out of bed you should not bend over right away. Try to keep your back straight or try stretching backward .
Next, use your hips to bend over the sink to brush your teeth.
The above picture is a great way to cause sharp shooting pain in the morning.
Sitting with a more normal curve in the lumbar spine helps take the pressure off of the lumbar discs and helps decrease pain.
Sitting like this cause more disc pressure causing disc irritation. It can cause the disc to bulge more.
Discs are fatter in the morning because the absorb fluid overnight. So think of a jelly doughnut if the doughnut has more jelly its more likely to shoot out if you put pressure on it.
So remember back straight, stomach tight will help prevent lower back pain and help you heal if you have pain.
This is a pretty cool picture. Can you believe the detail? The red in the picture is the muscle and the white stuff is the connective tissue is called fascia. A painful area in a muscle can be caused by damage to one or both of theses structures!