In Balance Chiropractic and Health Centre

Muscle imbalances

2009-03-12T08:11:00.000-07:00

When we run we always repeat the same motion over and over again. It's not surprising that most distance running injuries are caused by overuse.

When running, multiple muscles have to work in synergy to help us run efficiently. If some of these muscles are too tight or too weak, it will lead to muscle imbalances. A lot of runners tend to get these imbalances in their core and hip muscles. This often leads to the pelvis being unleveled while running or compensations with other muscles. I often tell my patients that your body is similar to your car. If your wheels are not properly balanced, your tires will wear down faster. Same thing happens in your body. If your hip and core are too weak, this will lead to misalignments in your hips, knees and ankles that will make your muscle wear down faster.

For example, a muscle called the psoas iliacus brings our thigh up during the running. It is an important muscle and is tight in a lot or runners. Because of its anatomy, when it's tight, it will also lead to a decrease in hip extension. In simple term our stride length will be shorter. Another thing to note is that when a muscle is tight in our body, the muscle that makes the opposite motion will usually be weak. In the case of a tight hip flexor, this means that our gluteus maximus will be weak. The gluteus maximus is one of the muscles that propel us forward. This will also lead to a decrease in our stride length. This ultimately leads to a decrease in performance.

The psoas iliacus is tight in a lot of people because it's in a short position most of the day. If you look at the anatomy of the muscle you will find that this muscle is in a short position when we are sitting. And most of us sit for many hours in a day. Some people have office jobs that require that they sit for 8 hours. We also sit to drive to work, we drive back home, we sit to watch TV, you see where I'm going. For examples of psoas iliacus stretching, you can visit my website at www.inbalancechiro.ca and click on exercise of the month.

The psoas iliacus is only one example of muscle imbalances. Muscle imbalances are detectable with proper testing and treatable with proper treatment, stretching and strengthening exercises. By preventing imbalances from happening in the first place you can improve your running performance and prevent injuries.

Hamstring injury

2008-06-24T12:51:00.000-07:00

Hamstring injuries are common in sports involving running. It is more common in sprinters but I also see a fair bit of long distance runners that pull there hamstrings. The main problem with hamstring strains is there high recurrence rate. Some studies suggest that one out of three athletes will re-injure there hamstring within a year of returning to there sports.

The hamstring is a muscle located at the back of your thigh. When you pull your hamstring muscle, there will usually be a tear in the muscle. This is followed by some bleeding and inflammation inside the muscle. Depending on the degree of the tear you may or may not see a bruise. Soon after, your body will start repairing the area by laying down scar tissue and new muscle cells will start forming.

Traditionally, these injuries have been treated with stretching and strengthening directed to the hamstring muscle itself. Due to the high reoccurrence of these injuries; clinician and researchers have been looking into other type of treatments for this problem. A study published by Sherry & Best (2004) published in the Journal of orthopaedic sports physical therapy has shown that agility exercise and core exercises might be better to prevent hamstring injuries from recurring.

When running, multiple muscles have to work in synergy to help us run efficiently. A lot of runners tend to get muscle imbalances in there core and hip muscle. When running these muscle imbalances often lead to the pelvis being unlevelled. The hamstring attaches right at the bottom of the “sitting bone” which is part of the pelvis. The hamstring is often called the weakest link of the chain. Therefore if your core and hip muscle are not working properly and your pelvis drops every step you take; this will lead to a constant pulling of the hamstring muscle. Over time, the hamstring gets overworked and strained. This could also explain why the study by Sherry & Best helped to reduce the reoccurrence of hamstring injuries, by rebalancing the core and hip muscles.

My personal approach to get athletes back to there sport as soon as possible also involve decreasing the inflammation in the initial stage of the injury (with ice). And after the muscle starts to lay down scar tissue, I use a few muscle treatment techniques. One of them is called Graston Technique. But, the injury can only be prevented from reoccurring by properly addressing the cause of the injury, which is the muscle imbalances present in the hip and core muscles.

Tendonitis or Tendinosis?

2008-03-20T07:44:00.000-07:00

A tendon is the structure that connects a muscle to a bone. Endurance athletes are predisposed to tendon injuries due to the prolonged stress that they put on there bodies. Often athletes with tendon injuries are diagnosed with “tendonitis”. The “itis” suffix means inflammation. For example, if someone is diagnosed with Achilles tendonitis this would mean that there is inflammation in there Achilles tendon. However, in the past few years scientific research has shown that tendonitis is rarely present in chronic injuries because there is a lack of inflammatory cells. Inflammation will be present in some cases, if it’s new injury for example. But if your tendon has been painful for a while and not getting better the proper diagnosis might be tendinosis. The suffix “osis” means; affected with, condition or abnormal process. In a tendinosis the tendon is affected with a degenerative process or a build up of scar tissues.

In my practice I rarely find tendonitis problem in endurance athlete but more often tendinosis. The importance of a specific diagnosis in this case will change your treatment. If you are diagnosed with tendonitis, the treatment will usually be geared towards reducing the inflammation. So you will use ice, you might even use anti-inflammatory medications. If you have a tendinosis the treatment will be completely different. The treatment plan will be geared towards breaking down the scar tissue. In my practice I use Graston technique and myofascial release techniques to break down that scar tissue. Eccentric loading exercises have also been shown to be effective in treating tendinosis. It is important to get a proper diagnosis and not try to treat yourself because there is a risk of getting worse or even tendon rupture.

To summarize, tendonitis is rarely seen in endurance athlete, tendinosis is more often found. Proper diagnosis will lead to proper treatment and help you get back to your sport faster and pain free.

Plantar Fasciitis

2008-01-27T15:00:00.000-08:00

I often get patients walking in my office with a complain of heel pain. There are multiple causes of heel pain one of them being plantar fasciitis (plant-er-fa-she-eye-tes).

What is plantar fasciitis?
The name plantar fasciitis is somewhat misleading. The suffix “itis” means inflammation. And the plantar fascia is a band of fibrous tissue that extends along the bottom of the foot from the heel to the toes. Therefore plantar fasciitis should mean inflammation of the plantar fascia. However, in recent years it has been found that there is usually no inflammation present. What has been found is degeneration in the plantar fascia (scar tissue).

What is scar tissue?
With overuse of the plantar fascia, tiny tears form in the tissue. In the healing process our body attempts to repair that fascia with scar tissue, much like that scar that forms on the skin when you have scrapped or banged your elbow. As you can imagine, scar tissue is not as strong and flexible as normal, healthy undamaged tissue. Over time we can have a build up of this fibrous scar tissue if too much stress is put on the plantar fascia. This can lead to pain and dysfunction because this replacement tissue lacks the strength and flexibility of healthy tissue.

What are the symptoms of plantar fasciitis?
The classic symptoms of plantar fasciitis is pain under the heel that is worse in the morning or prolonged period of rest. The first few steps are really painful and that pain decreases with walking. When more advance there is also pain during normal activities.

How is plantar fasciitis treated?
Rest, ice and anti-inflammatory have traditionally been advised for plantar fasciitis with limited results. Some people may have this pain for months and even for more then 2 years with improper treatment. Since there is usually no inflammation but a scar tissue build up it important to break down the scar tissue. One soft tissue treatment technique that I use in my office is Graston technique. Patients usually notice an improvement of there symptoms on the first treatment. For more information on Graston technique visit my website at www.inbalancechiro.ca

How's your balance?

2008-01-02T14:27:00.000-08:00

One thing I always do when I get athletes coming in my office with lower limb injuries, is to check there balance. Balance is an essential function of the locomotor system. It is often ignored but no less important than flexibility, strength, endurance, or aerobic fitness. Balance is an important part of the rehabilitation of certain injuries. It is also important part of injury prevention programs in runners. Balance training has been shown to improve strength in the hips and legs and is less time consuming than strength training programs. It’s also important to note that in the past few years research has shown that people with weaker hip muscles tend to get more leg and low back injuries.

Poor balance in otherwise healthy individuals may be due to previous injuries that were not properly rehabilitated, muscle imbalance, poor sensation coming from the sole of your feet, or other causes. Balance depends on the somatosensory, vestibular and visual systems. The somatosensory system gets sensory information for balance from the soles of the feet, the neck, and the lumbar spine for inputs. If two of the previously mentioned systems are not working properly, our balance will be affected.

Do the following test at home. Stand on one leg. Begin with eyes open and practice once or twice on each side. Then by looking straight ahead close your eyes and try maintaining your balance. If the foot touches the opposite leg, hopping occurs, the other foot touches the floor, or the arms touch something for support the test is stopped. You have 3 chances on each side to reach your best time.

Depending of your age you should be able to stand on one leg, eyes closed for a minimum of the following length of time.

20-49 year of age→ 24.2 seconds
50-59 year of age→ 21.0 seconds
60-69 year of age→ 10.2 seconds
70-79 year of age→ 4.3 seconds

If you can’t reach these times it may be important for you to get assessed to determine the cause of your poor balance and prevent injuries.

One easy exercise to work on your balance is to try holding your balance on one leg for 30 seconds. Perform the routine three to four times per leg twice daily until you can comfortably keep balance for 30 seconds. After that proceed with your eyes closed until you reach 30 seconds again.

Hip Flexor...important muscle

2007-12-05T18:33:00.001-08:00

Runners and endurance athletes are a big part of my chiropractic practice. A common problem that I see in a lot of athletes is tight hip flexor muscle. This contributes to a decrease in performance and an increase in injury. For example runners with hamstring problems often have tight hip flexor as well.

The hip flexor is also called psoas-iliacus muscle. There are other muscles that help with hip flexion but this is the main one. The psoas-iliacus can be divided in two; the psoas has its origin on the entire lumbar spine, the iliacus on the posterior of the ilium. They both join to attach at the top and inner side of your femur.

The hip flexor brings our thigh up during the running. It is an important muscle and if it gets tense it will usually get weak as well. Because of it’s anatomy it will also lead to a decrease in hip extension. In simple term our stride length will be shorter. Another thing to note is that when a muscle is tight in our body, the muscle that makes the opposite motion will usually be weak. In the case of a tight hip flexor, this means that our gluteus maximus will be weak. The gluteus maximus is one of the muscles that propel us forward. This will also lead to a decrease in our stride length. This ultimately leads to a decrease in performance.

Why is hip flexor so tight in a lot of people?
Well if you look at the anatomy of the muscle you will find that this muscle is in a short position when we are sitting. And most of us sit for many hours in a day. Some people have office jobs that require that they sit for 8 hours. We also sit to drive to work, we drive back home, we sit to watch TV…you see where I’m going. Sitting is in my opinion the main cause but there are also other causes.

I often talk to groups of runners and I ask people in the audience if they know how to stretch there hip flexors. It is always surprising that most people have never stretch there hip flexors. It is impossible to explain how to stretch your hip flexor properly in an article. So the best thing to do is to ask your coach, chiropractor, physiotherapist, athletic therapist or anyone else that is competent.

Muscle imbalances are detectable with proper testing and treatable with proper treatment, stretching and strengthening exercises. By preventing imbalances from happening in the first place you can improve your running performance and prevent injuries.

Hope this makes sense.

Graston Technique

2007-12-03T10:21:00.000-08:00

We have all experienced injuries that don’t seem to go away or always tend to come back. One of the reasons could be a build up of scar tissue in muscles. In the healing process our body attempts to repair muscles, tendon and ligaments with “scar tissue”, much like that scar that forms on the skin when you have scrapped or banged your knee. As you can imagine, that scar tissue is not as strong and flexible as normal, healthy undamaged tissue. Over time we can have a build up of this fibrous scar tissue, particularly in the muscles, tendon and ligament that get a lot of use. This can lead to pain and dysfunction because this replacement tissue lacks the strength and flexibility of healthy tissue (in some areas it may even mat down and entrap a nerve).

A soft tissue treatment technique called Graston Technique allows us to better detect and treat these areas because it uses a stainless steel instrument that glides along a patient’s muscle, tendons or ligaments and acts like a “scar tissue” stethoscope. When knots or bands of scar tissue are encountered, both the doctor and the patient sense a restriction or a granular feeling. The instrument can then be used to “break up” this restriction or adhesion. After treatment there is usually a decrease in pain, increase flexibility and increase in strength in the muscles.

The following are some of the more common conditions that respond well to Graston Technique:

Tennis elbow
Carpal Tunnel Syndrome
Back pain
Plantar Fasciitis
Rotator cuff tendonitis
Reduced range of motion due to scar tissue
Achilles (Heel) pain
Post surgical traumatic Scars
Myofascial Pain/ Restrictions
Iliotibial Band SyndromeWrist tendonitis

For more information regarding this technique visit www.grastontechnique.com

Dr. Steve Pelletier
In Balance Chiropractic and Health Centre
www.inbalancechiro.ca

Hatha Yoga and Yoga for runners

2007-12-02T08:57:00.001-08:00

We will officially start our first yoga classes on January 7th 2008.

One class will be designed for runners. It will be held Monday mornings from 7 am to 8 am. This is a great cross training exercise for runners. This beginner program will be designed to teach proper breathing, proper body alignment and we will also focus on stretching those tight muscles that runners tend to get.

The other class will be a beginner Hatha yoga class. This one will be held on Tuesday mornings from 7 am to 8 am. This class will also focus on proper breathing technique, proper body alignment and proper technique.

Both classes will be limited to 5 participants per classes to make sure that everyone gets proper supervision and feedback from the instructor. They will be of 8 week duration and the cost is $96. With only 10 spots available the classes will fill up pretty quickly. To reserve a spot email us at inbalancechiro@gmail.com.

Dr. Steve Pelletier

New Chiropractic and Health Centre in Orleans Ontario

2007-11-28T05:59:00.000-08:00

Welcome to my blog. My name is Dr. Steve Pelletier and I am a Chiropractor located in Orleans, ON. After a couple of years working as an independent contractor in Orleans, I have decided to open my own health centre.

This centre reflects my philosophy towards the treatment of muscle and joints injuries as well as my philosophy towards health. This new health centre is called In Balance Chiropractic and Health Centre. The name reflects what we aim to achieve with our patients. By recreating a balance in people’s muscles and joints we want to help them heal from injuries and prevent those from happening in the future. Our main goal is to help our patients heal as fast as possible by using the most current and evidence base treatments available.

The clinic is located at 2034 St. Joseph Blvd. Unit 4. We offer: Chiropractic Treatments, Massage therapy, Orthotic, Graston technique and Yoga.

Dr. Steve Pelletier
In Balance Chiropractic and Health Centre
2034 St. Joseph Blvd. Unit 4
Orleans, On
613-837-8885