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IT Band Pain? Think TFL

Nearly everyone that has participated in distance running, or functional training has likely experienced hip discomfort at some point either in training or competition. Many people are quick to blame their IT Band, and proceed to beat the tissue to a pulp via their foam roller, dog toys, spoons, baseballs.. I have heard it all.

While there is some benefit to rolling out the vastus lateralis (under the IT band), foam rolling is highly over rated. A bit about the anatomy: The IT Band, short for iliotibial band, is actually not a muscle but fascia. Actually, it’s one of the largest pieces of fascia in the body.The purpose of this fascial sling is to provide spring during gait , and it is also thought to help to stabilize the hip. The point is the IT band is not the enemy, in fact you may be abusing an already over worked piece of tissue.

What is the TFL? The TFL short for Tensor Fasciae Latae is a small triangular shaped muscle. If you have hip pain right now I would bet it is tender. To find the muscle, locate the pointy bone just anterior and lateral to your belt line, this is known as your ASIS. From this point work your way around your waist line and you may notice some tenderness between your hip flexors and glutes, this is where the TFL muscle lies. This muscle will insert on the IT band and serve to regulate length and tonus of the band. Along with aiding in hip flexion and internal rotation, the TFL muscle is also a hip stabilizer (think alignment on a car).

Why the TFL? If you follow along my blog you know that I believe many of our muscluloskeletal problems come from lifestyle, and poor or incorrect posture causing excessive wear and tear. The same can be true here, when we adapt to a sitting posture (if you commute an hour each way to work and then sit at a desk all day, this is you). The hip flexor’s become excessively tight as well as the lower back muscles. On the other end, the glutes and abs become neurologically inhibited due to the fact that they are not needed when you are sitting. The problem is, when you do run, or get active these muscles forget to do their job. Fortunately (and unfortunately) the TFL is already in a “hyperactive” state due to being shortened (contracted) all day. This means that this muscle is now doing all of the stabilizing work of the glutes. I like to use the analogy the TFL is like a VW trying to pull a an eighteen wheeler. It simply is not possible without harm.

So there you have it, now give that IT band a rest!

We have great success resolving hip pain for many people. Call or Contact Us online and see how we can help you: (781) 460-0939

Keep Moving.

Dr. James Ellis

www.evolvedhealthchiropractic.com

What is Piriformis Syndrome?

One common complaint in just about every Chiropractic clinic is that of the dreaded “Sciatica.” Contrary to many people’s beliefs “Sciatica” is not a diagnosis but rather a symptom. Sciatica simply means that someone is experiencing pain or discomfort in their back and leg. The question that the clinician must answer is always; “why is this happening?” Scatica can be the result of a few different diagnoses. It could be the result of a nerve being pinched by a disc herniation, it could be the result of arthritis, or quite commonly it is caused by tight muscles in the back, glutes and hips.

So what is “Piriformis Syndrome” and what does it have to do with sciatica? One common cause of sciatic nerve impingement is the piriformis muscle. This muscle lies deep to your glutes and works as and external rotator of the leg. In majority of people the sciatic nerve passes underneath the piriformis muscle, however in some the nerve passes through the muscle making it more susceptible to impingment. Most patients presenting with this condition complain mainly of deep, dull gluteal pain. This can also be experienced as burning and tingling in the leg which is noted by many people depending on position. One of the main causes of piriformis symdrome is poor biomechanics of the pelvis and spine. This could be due to muscle imbalances, poor posture, or simply an increase in training intensity or change in terrain. When the muscle becomes too tight, it spasms compressing the neve causing you pain!

Runners pay attention, this is one of the most common problems runners present with in my office! Why? Running is very linear, relying mostly on the glute maximus for hip extension and the quads for hip flexion. This means that the glute maximus will often develop trigger points causing spasms which will compress the prirformis muscle.

A few tips for prevention:
•Your body is like a high peformance car, it is very in-tune and even the smallest deviation can cause major problems. See a Chiropractic Physician! Poor biomechanics will always lead to issues.
•Warm-up before your work-out’s with light jogging or walking.
•Stretch your hamstrings, calves, and glutes

Think you may have Piriformis Sydrome ? We have successfully helped many runner’s and athletes with this condition. Give us a call! (781) 460-0939

Keep Moving.

Dr. James Ellis

www.evolvedhealthchiropractic.com

3 Exercises that Every Runner Should be Doing

Any avid runner will tell you they are always pushing themselves to hit a PR. The problem is, over-time the harder we push our bodies the more likely that they are to break down!

Since running is very linear some of the more common injuries that prevail are those of over-activity, or tendonitis. If you are not already doing so, you should and will need to include cross-training or weight training days if wish to continue to improve at a healthy pace. By working a few key problem areas you will not only increase your PR, you will decrease the likelihood of an injury. Try these 3 exercises below on your next cross-training day and enjoy a faster, healthier run.

1.The Scapular Retraction- Have you ever had anyone film you running a race or an event? If so, you undoubtedly noticed the change in posture from the begging of the race to the end. In the beginning you were likely chest up, head-up, torso engaged. As our bodies wear and our muscles get tired your shoulders will slowly begin to round forward pulling your head forward. This will not only increase the pressure in your spine, it will decrease the amount of blood and oxygen your body is able to transport to your lungs and brain. Posture is very important to running and gait! by engaging your rhomboids it will ensure better posture even when you are fatigued.

2. The Plank- Like upper body posture, lower body posture is equally important. Many runners tend to have over active hip-flexors and lower backs. This is usually always a compensation pattern for a weak core. The core muscles must contract during all phases of gait and running, ensuring a stable lower back and pelvis. Stability= healthy hips and lower back. Lumbopelvic instability in runners leads to injuires such as: runners knee, piriformis syndrome, and hip bursitis.  The plank is very effective at circumferential activation of the core (it works all of the muscles).

3. Foot Drills– It is our feet that take the brunt of the force when we are running. Even with proper fitting shoes, muscles become tight and often times inhibited leading to issues such as pronation. This will cause issues such as Achilles Tendonitis, or Plantar Fasciitis. Try these drills below to target the key muscles in your feet involved in running and gait.

Interested in learning more? Click Here for instructions on how to complete these exercises!

Dr. James Ellis

www.evolvedhealthchiropractic.com

(781) 460-0939

Improve Your Posture and Prevent Injury

Perhaps now more than ever people are aware of their posture and the ill effects it may have on their health. And for a good reason; recent research has suggested that the effects of poor posture are shortening our life span!

In the short term, posture can wreak havoc on our musculoskeletal system. The classic “rounded shoulders and hunched back” posture that many of us have began to develop due to our sedentary lifestyles causes muscle imbalances, impingements, and tendonitis. This is due to the compressive nature of poor posture. Over-time, these effects become more difficult to reverse. For anyone who is active this is a bad news! The resulting muscle imbalances lead to altered rhythm of the hips and scapula, making a shoulder or lower back injury more likely.

Chiropractic care is essential to good posture. If you are already noticing discomfort in your neck and lower back now is the time for intervention. If you are concerned about your posture but don’t have any pain currently don’t wait! Spinal manipulation and myofascial release is essential for anyone who spends a lot of hours sitting at a desk. By freeing the joints and muscles we can break the break this cycle and re-educate the muscles restoring proper biomechanics preventing pain and injury. This means less chance of injury, and more fit, functional physique!

Interested in fixing your posture? Call today and schedule an appoinment: (781) 460-0939

 

Keep Moving.

Dr. James Ellis

www.evolvedhealthchiropractic.com

Conservative Management of “Runner’s Knee”

A chronically painful knee can be not only painful for the athlete but can also be very difficult to diagnose. This is because often times the pain can be vague and seem to “come and go.” After ruling out any more serious complications, I find one common cause of knee pain is known as “runners knee” otherwise known as patellofemoral pain syndrome. This is characterized by vague pain behind and around the knee cap often made worse with activity, bending,  and going down stairs. Mild swelling may also be noted. The cause is typically multifactorial and usually related to over-use. Muscle imbalances in the legs resulting from pelvic, knee, and feet alignment issues are typically present.

How is it Diagnosed?

A physical exam will be performed with range of motion and orthopedic testing of the knee. You doctor may also order an X-Ray or MRI if he feels necessary. Pain is often noted in deep flexion especially when weight bearing(such as squatting) and is frequently felt behind the knee often made worse with activity.

How is it Treated?

Step number one is to consult your physician and have the knee examined. Most cases of runners knee require some professional intervention or they may become chronic. Initial treatment may include passive modalities such as ultra-sound, muscle stimulation, or heat. The alignment of the knee, hips and feet will need to be addressed by a chiropractic physician. Additionally, rehabilitation exercises should be prescribed in order to correct the underlying problems with muscle imbalances. This can be corrected through techniques such as myofascial release, manipulation, and therapeutic exercise.

The bottom Line

Consult a chiropractic physician or sports medicine doctor for an accurate diagnosis and to rule out more serious pathologies. The treatment plan should include a multifactorial approach including passive modalities, manipulation of any joint dysfunctions, and therapeutic exercise to correct muscle imbalance’s.

 

Keep Moving.

 

Dr. James Ellis

www.evolvedhealthchiropractic.com

Chronic Ankle Sprains? Fix Your Feet With These Simple Drills

Most active people have suffered an ankle sprain at one time or another accompanied by swelling, pain, weakness, and a long road to complete recovery!  Many runners and athletes may find themselves more susceptible to future sprains and strains even after the initial problem has resolved. This is because soft-tissue healing can take anywhere from 12-18 months and there is usually always involvement of one or more ligament!

A bit about the anatomy of your ankles. The ankle is held together by several ligaments: on the inside of the ankle you have the deltoid ligaments (less likely to sprain) among others, and on the outside of the ankle you have the anterior and posterior talofibular ligaments a long with the calcaneofibular ligaments to name a few. Most sprains/strains of the ankle occur from excessive plantar flexion and inversion (about 80%) affecting the lateral ligaments (most commonly the anterior talofibular ligaments). These ligaments (even when over-stretched and not torn) take a very long time to heal and when no treatment is given to promote healing will cause the tissue to heal abnormally (think of a patch over a hole) causing less tissue extensibility and improper function. Remember, there is no blood supply to the tendon itself.  Over-time this exacerbates muscle imbalances and leads to a chronic biomechanical deficit. This being said, some intervention is necessary to ensure that the tissue heals properly to prevent future sprain/strains.

In the early stages of an ankle sprain your doctor or therapist should advise a couple of days of rest and elevation. In addition to resting and elevating at home your doctor should also recommend manual therapy techniques to facilitate healing. This may include manipulation of the joint, traction, heat, myofascial release, and eventual therapeutic exercise. It is very important to address joint stiffness early on to ensure proper movement and healing.

“Weak ankles” become an issue when the tissues discussed above heal improperly; usually because no treatment was received. This will exacerbate existing muscle imbalances leading to dysfunction making you more susceptible to injury. The solution to this issue is to reestablish appropriate movement and fix muscle imbalances. Most athletes I see that suffer from chronic ankle sprains exhibit deficits in their gait, hips, and lower leg muscles. These deficits have likely been an issue for a long time and have continued to build until an injury occurs.

Does this sound like you? First, have your gait evaluated by your doctor or therapist, then try these simple drills to help balance the muscles in your feet and lower leg. You will notice a stronger, more athletic ankle!

All drills to be performed shoes-off (except for walking on your heals) and for a length of about 25 meters; preferably on grass or any hard surface:

  1. Walk with feet inverted
  2. Walk with feet toe-in
  3. Walk backwards on your toes
  4. Walk with feet everted
  5. Walk with feet toe-out
  6. Walk on heels

Dr. James Ellis

www.evolvedhealthchiropractic.com