20
Nov 2013
The human foot is a complex and dynamic structure and the proper function of the foot is crucial for optimal health of the entire body. The foot has 26 bones and 33 joints, and over 100 muscles, tendons and ligaments. To say that there is a lot going on down there is an understatement. Additionally we rely on the foot to be a shock absorber, and also our platform of stability for the other joints in the body above. So why do many of us ignore the strength and health of our feet when we need them so much? Many injuries that I encounter, athletic or otherwise are caused or affected by improper foot function. Two common examples are improper mobility in joints of the mid foot or great toe, and weakness in the muscles and plantar tissues (the arch). When the joints of the mid foot or the first toe are restricted, it causes either excessive supination or pronation (rolling inward or outward of the foot) and this leads to many other injuries as well as aches and pains. Injuries like bunions, shin splints, Achilles tendinitis, Illiotibial band syndrome, patellar tendinitis, hip and low back pain can all begin with improper foot and ankle function. Having weak feet is something that many of us should be concerned with. Especially this time of year as the weather cools and we spend less time in sandals, barefoot, and light shoes the feet become less active. When the muscles in the feet are dysfunctional or weak the spring-like effect of the plantar fascia is lost. It is also harder to “work through” the foot, rolling from heel to toe and springing off. This reduction in roll through can also impact how the glute and posterior chain function, and our stride becomes less efficient. Foot strength and mobility can be easily developed through specific soft tissue treatment protocols and chiropractic adjustments of the joints. The other components are numerous rehabilitation exercises. For example, towel curls, balance and proprioceptive drills, stretches and simply spending time walking barefoot, especially in grass and sand are a few of the effective techniques that we use.

06
Nov 2013
Why Cold Water Therapy? Ice baths and cold water therapy are proving to be a neccessary part of serious athletic training and rehab programs. Faster Exercise Recovery: Recovery is an important aspect of any intense sport or physical conditioning program. However, many athletes train extremely hard without giving their body time to recover properly, which can lead to burnout and poor performances. Shortening recovery time results in a competitive advantage. The ability of the body to clear or remove lactic acid (aka Lactate or H+) from the tissues is one of the limiting factors in exercise recovery. Cold therapy speeds this process up by causing superficial blood vessels to constrict, effectively “squeezing” these metabolites out of the muscles and tissues into the deeper blood vessels where they are diluted and neutralized by the body. The reduction of swelling (aka inflammation or oedema) caused by intense exercise is also a limiting factor in recovery time. Swelling is controlled by the lymphatic system rather than the circulatory system and relies on mechanical forces such as gravity and external pressure to move its contents. The buoyant water pressure and massage delivered by the coldtub provide these external forces, speeding up recovery time. Reducing sympathetic nervous system activity is another important factor in exercise recovery. Intense exercise stimulates the sympathetic nervous system to increase adrenaline production, which if left unchecked can cause the athlete to ignore the signs of fatigue, causing them to burn out or get injured. Put simply, cold therapy dampens the adrenaline rush so the athlete feels like taking a needed break from activity. Cold Water Pain relief and Injury Treatment:Intensive exercise causes Delayed Onset Muscle Soreness (DOMS), which peaks between 24 and 72 hours after the event. Cold water therapy reduces DOMS pain by reducing the muscle inflammation and spasm that cause it. The principle is the same for treatment of acute injuries. Cold therapy is used in both cases with proven benefits because the cause in both cases is tissue damage. Small micro-tears in muscle causes DOMS and large-scale tissue damage causes acute injuries. In fact, cold therapy delivered by a Coldtub is also an excellent treatment for acute injuries, even better than an ice pack or cold compress in many ways. Faster Injury Recovery: Using a cold tub or ice bath reduces injury recovery time. Cold therapy is already used to treat acute sport injuries. More training – Less Downtime – More Playing – More Winning!

09
Oct 2013
At Fix Body Group we are bombarded weekly by injuries and trauma to the shoulder, especially the rotator cuff muscles. Most people have heard of injuries and tears to the rotator cuff. Whether you are a Crossfit athlete, baseball fan, desk jockey or weekend warrior in a local gym, everyone fears the rotator cuff and the pain and suffering an injury there is supposed to coincide with. However, as we will describe below, often these injuries are extremely treatable and have a very high success rate, if the proper approach is taken. While by nature, especially compared to the hip or other joints, the shoulder in naturally less stable, these type of injuries are often very preventable and can also be healed very successfully with conservative physical and manual therapy methods. We employ a mix of sports therapies, A.R.T. , massage, and chiropractic work to help re-balance the shoulder by strengthening weak muscles and relieving tightness and scar tissue buildup in tight muscles, ligaments and tendons. Lately, we’ve encountered a number of problems that have to do with one rotator cuff muscle in particular, the subscapularis. The subscapularis, or “subscap” as it’s often called in short, is extremely important for both normal function of the shoulder joint, and also the healing of an injured shoulder. Because it lies beneath the scapula (and thus derives it’s name), and posterior to the rib cage it is very hard to access and treat, except by the most skilled and knowledgeable of therapists. Many doctors, massage therapists and PT’s don’t really know how to access it for manual therapy, and there are few ways to really create a positive response in this muscle otherwise. The subscapularis will become very tight in swimmers, ballplayers, surfers, boxers, Crossfit athletes, and anyone who uses a mouse, keyboard, or steering wheel for long duration. You might know this muscle is affected if you have trouble bringing your arm up overhead and rotating externally, as if winding up to throw a baseball. If you have trouble with these motions please consider getting an assessment to find out if this muscle, or another rotator are compromised. This muscle is not easily stretched or lengthened at home, and is best treated using an advanced manual therapy technique such as Active Release Technique as we do here at Fix Body Group. Many of our desk jockies, Crossfitters, and professional fighters can attest to the powerful change that can be made on this muscle, and ultimately the entire shoulder joint.

01
Oct 2013
A recent review on research of shin splints (or medial tibial stress syndrome) in the journal Sports Medicine has given many athletes suffering from the condition little hope. Dutch researchers concluded that, “no intervention has been proven to be effective for medial tibial stress syndrome.” In the study, groups of people received various common treatments for the injury in contrast with those who did not. Examples of the treatments used were leg braces, ice massage, ultrasound, extracorporeal shockwave therapy, and iontophoresis. The study concluded by recommending short periods of rest from weight bearing activity to allow the bone to heal. This is standard advice in the medical community, and the treatments studied in the article are also typical, if conservative methods for sports medicine practitioners. The problem with approaching this sort of injury with conservative, standard treatments and rest, is that it fails to decipher how the injury occurred, and if it will return once the activity is resumed. Most injuries don’t just come about in one location independent of everything else going on in the body. An injury like shin splints is the final product, which is the painful conclusion, but usually a progressive buildup of other developments in the body lead to it. This project also neglected to study whether other treatments such as A.R.T., Myofascial release techniques, massage, and changing of running mechanics, and corrective exercise would help heal the injury quicker. In my experience, this sort of injury when treated holistically and by addressing biomechanics, can be resolved very quickly. Weekly, we see runners in our clinic with shin splints that are resolved in a few treatments, and often can continue to train through the injury and treatment process. Here’s my standard approach to treating shin splints: 1. Look at the patient’s biomechanics: Often there is too much pronation, or external rotation of the legs. At what angle does their lower leg contact the ground? Often it will be an angle greater than 90 degrees. Often there is glute weakness and some tightness in the anterior hip. 2. Corrective exercises and strength training for the weak muscles done daily at home. Stretching and foam rolling for the tibialis anterior and posterior, soleus, and peroneals and quadriceps. 3. Myofascial release and A.R.T. for the lower leg and quadriceps, TFL, and psoas. 4. Running on soft surfaces only, depending on severity and treatment frequency 5. Address shoe choices and recommend changes depending on the type of runner, mileage, training surface, and biomechanics 6. Ice cup massage for the shin, compression socks if travelling or sitting a lot.

10
Sep 2013
NSAID-List A recent topic in the athletic world is the role of inflammation in healing and adaptation to training. This is particularly of note to our running, cycling, and triathlete patient base that train many hours per week and are constantly at war with inflammation, pain, soreness, and fatigue. This topic is fleshed out in greater detail in an excellent blog linked here: If you don’t have time to read the article (which you really should take the time) I will outline some of the main points. 1. Inflammation is often a desired, and necessary response to injury or training. Without it, adaptation can be less effective. 2. NSAID’s (or Non Steroidal Anti Inflammatory Drugs) inhibit training adaptations in muscle according to research. 3. Recent studies show that anti-inflammatory drugs don’t always reduce pain. This flies in the face of what is commonly believed and thus brings into questions of placebo with NSAID’s. 4. Use of NSAIDs sparingly and in the acute injury phase is recommended. At Fix Body Group we often recommend the use of NSAID’s but the timing and types of issues always are brought into play in making these decisions. While this must always be dealt with on a case-by-case basis, we generally approve of the suggestions in this blog. Using NSAID’s (and let’s not forget ICE!) in the acute but not chronic phase of injury is recommended. Icing as done by many runners and endurance athletes such as ice baths, along with use of NSAID’s to treat general training soreness is not recommended. This goes hand in hand with what the elite athletes I’ve worked with for years are doing. Elite athletes often take doses of NSAID’s and use ice baths during competitions, so that they can prepare for the next round or day without care for training response from the event. In training they typically limit or avoid these practices to allow their body maximum adaptation to the training stimulus. Remember, soreness is a good thing in training, it means you have taxed the fibers and musculoskeletal system. Soreness can also be thought of as a governor, forcing your body to slow down for a few days until both the metabolic, nervous, and musculoskeletal systems are recovered and ready for more. If you acquire a simple ache, tendon injury or something that is more than general soreness consult with your health care professional and generally some advil for about three days would be a good idea. If you have questions about different kinds of soreness or what you should do in these scenarios please leave comments below or call to speak to one of our providers. Happy training!

28
Aug 2013
The Fix team will be out in force at the Pacific Beach Movin’ Shoes store to provide injury screening and diagnostics this Saturday 8/31, from 9-11:30am. Our team of chiropractors, therapists, and trainers will analyze your imbalances and deficiencies and suggest action steps for improvement. Movin’ Shoes will also hold a labor day sale so if you need some shoes or would like to get recommendations for shoe choices make sure to come by also. Knowing your physical risks and limitations through our injury screen will be helpful when you go to purchase shoes. Thanks to Movin’ Shoes and we’ll see you all out there! Check out facebook here to get more information: https://www.facebook.com/events/430896390356516/438268076286014/?notif_t=plan_mall_activity

22
Aug 2013
We would like to thank San Diego’s Free to Breathe and race director Roger Drews of Challenger Productions for a great event this morning!!! This community race does great work to support Lung Cancer.  We were in Point Loma bright and early Saturday to donate a raffle prize and do some work on injured walkers and runners.  Special congrats to team member Jonathan Pierce for winning their 5K this morning! Proud of you Jon!   teamJ&S 2

29
Jul 2013
Dr. Robek and a few patients suffering with shoulder and lower back conditions attended a private aqualogix group class at FIT in Downtown.  A big thanks to Jon Edge who instructed the class and kept us motivated when we were starting to fatigue. This was tough!  Aqualogix is a great work out and a safe way to use water resisitance for rehabilitation of an injury, especially shoulder and hip. Water resistance is extremely effective for people of all ages and abilities, and is safer than traditional weight training.  You can visit aqualogix.com for more information. We have been treating a number of shoulder injuries lately such as frozen shoulder, rotator cuff tears and strains, trauma to the shoulder during contact sports, and subluxation/dislocations of the shoulder.  Often these injuries result when the patient has imbalances or instability in the joint due to dominance of certain muscles such as the Pec Minor/Major or Subscapularis and weakness of other opposing muscles of the rotator cuff.  By nature, the shoulder is a weak and unstable joint, it’s important to ensure that it is balanced and strong before undertaking any aggressive exercise program.  If you want to understand more don’t hesitate to come in for an assessment or personal training session at Fix Body Group.  We can prehab or rehab any shoulder injury that you might have or incur in the future.
FIT-Aqualogix

FIT-Aqualogix

01
Jul 2013
We are pleased to announce the recent addition of the newest therapist, Jeff Lacson to our team. A Holistic Health Practitioner (HHP), Jeff will be providing massage therapy and doing myofascial release and structural integration.  Jeff will work closely with Dr. Robek and Jonathan to further complement the various modalities utilized in our clinic.  Jeff has become an expert in treating postural faults, chronic pain, and overuse injuries.  He has extensive experience working with CrossFit athletes, Martial Arts, body builders, runners, and triathletes.  He currently trains in martial arts and does CrossFit. Many of our patients have already seen rapid improvements in mobility, posture, performance and a decrease in chronic pain and injury symptoms due to Jeff’s care.  If you haven’t been getting regular massage, or are looking for a new approach, don’t hesitate to schedule an appointment with Jeff today!

21
Jun 2013
Fix Body Group’s soft tissue specialist Jonathan Pierce had the privilege of being contracted to work on the elite runners who travelled from all over the world for the Rock ‘n’ Roll 1/2 marathon.  He had a busy few days treating athletes from Japan, Kenya, Ethiopia, the U.S., and Zimbabwe as they completed final preparations for the race.  Treatments were focused on fine-tuning muscle tightness and aches the athletes had, and helping them improve circulation, blood flow, and flexibility after all the travel.  Many athletes arrived only 3 days before the race, and after long travel, thus the need for optimal recovery and optimizing their bodies. The elite half race this year was incredible, as it featured a blazing fast start on the men’s side, and a tactical nail-biter on the women’s.  Congratulations to Bernard Koech on running the fastest time ever on U.S. soil in 58:41.  Bernard is a great character, funny, quick-witted and immensely talented.  He might break the world records for either the half or full this year it seems. See you out next year for SD Rock ‘n’ Roll!
World Champion Eliud Kipchoge of Kenya, Jonathan Pierce(FixBodyGroup)

World Champion Eliud Kipchoge of Kenya, Jonathan Pierce(FixBodyGroup)