Posts Categorized: Rehabilitation
Here at FIX Body Group, our passion is getting you back to doing what you love to do, pain-free. The Runner’s Box is the newest addition to our repertoire of tools for doing just that.
Jonathan Pierce, our Soft Tissues Department Head has this to say about it.
“The Runner’s box is a foot strengthening tool for non-runners and runners alike, anyone with a foot condition or people who spend a lot of time restricted in shoes and on very predictable surfaces. The box is filled with stones that when walked upon force the toes and foot to behave differently, to work harder and build up the small muscles deep in the bottom of the foot. It also relieves the ligaments and joints of the foot as they have unusual pressure and stress placed on them. Patients can do specific drills and protocols to build foot proprioception and strength.”
For more information on exactly what the Runner’s Box can do for you, give us a call! You can also email Jonathan directly at firstname.lastname@example.org. Pictured below.
If any of these sound familiar, raise the alarm and head to FIX Body Group to consult with one of our on-staff, professional physical therapists.
It’s a runner’s worst fear: you’re running when it suddenly feels as if something jumped up and bit you in the calf. You tore a muscle.
The good news is that with rest and rehab, you’ll be back on the road in no time. However, some injuries are not so obvious and can be trickier to treat — that nagging pain in your left glute or the ache in your right knee that starts 45 minutes into every run.
How do you know when the injury is serious and requires a visit to a physical therapist? Ashleigh Bordwell, a PT at Rehab United in San Diego, offers six ways to determine when it is time to see a physical therapist.
1. Pain lingers after three or four days of resting and icing
At the onset of any ache or pain, the best plan of attack is to take a few days off from the sport that brought on the injury and spend 20 minutes several times a day icing the affected area. “The best thing with any injury is to give yourself a few days off,” Bordwell explained. “And then get back into your sport to see if your symptoms have gone away or if they’re still occurring.” If you have taken several days of rest and the pain continues to come back, it is time to see a physical therapist.
2. Reoccurring dull pain
Pain often subsides with rest and icing. But with more serious injuries, symptoms will repeatedly come back and linger until the underlying injury has been addressed.
3. One traumatic event
Some injuries, such as muscle tears and broken bones, are easy to spot, as they are brought on by one traumatic event. “If you watched yourself roll your ankle and it swelled up, or after swimming, you slipped and fell getting out of the pool, you’re going to want to come in and get it checked out,” said Bordwell.
4. Meds don’t control the pain
|Many endurance athletes are used to aches and pains. “It comes with the territory of being an endurance athlete,” Bordwell admitted. However, if over-the-counter anti-inflammatory and pain-relief drugs aren’t offering any reprieve, get it checked out.
5. Pain is acute and sharp
Dull, lingering pain is most likely treatable with rest and ice. But if the pain is sharp and centralized, this can be an indication of a more serious injury such as a muscle pull or stress fracture.
6. Noticeable or visible changes
You know your body best, and the more experienced you become, the more in tune you’ll become with your body. “If at the end of a day of training you notice your ankle is swollen or if you can’t pull as well on your left arm as your right when swimming, you’re going to cause one injury to get worse or cause another injury if you don’t see a PT,” Bordwell said.
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.
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!
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:
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.