Active Care Rehab

Squat Mechanics

Squat Mechanics

I wanted to share these videos on proper squat mechanics and how you should squat. Key points are proper ankle motion and hip motion. If you can not properly move through the ankle and hips your squat will suffer, actual your knees will suffer. See my article on posterior hip motion and exercises here. Also, need ankle more ankle motion these exercises can help.

Active Care Rehab

Achilles Tendinitis

AchillesAchilles tendinitis plagues many active individuals (runners to bikers) and the on the go hard worker. In fact, in a military study 10 of the 69 cadets who participated suffered an Achilles overuse injury. The Achilles tendon is placed  under intense strain everyday, with every movement. During running the tendon can be placed under forces seven times greater than body weight. It is no wonder that it is injured so frequently.

This injury is associated with pain in the back of the lower leg from the heel to five inches above. Achilles tendinitis, more appropriately called tendinosis, can occur in the high arched and low arched individual. Most commonly the injury is due to overuse rather than an accident. Chronic tightness in the calf muscles cause increased stress on the tendon. The Achilles begins to tighten and become sore over time and eventually the injury ensues.

Instead of using heel lifts and orthotics, rehabilitative insoles and gentle lengthening of the calf is a better approach. Aggressive stretching can cause increased stress on the tendon and increase the damage to the structure. Relieving trigger points in the muscle bellies with massage or foam rolling followed by gently dynamic, multi-planar stretching appears to be the best protocol for recovery.  If pain is worse in the morning a Active Ankle Dns Dorsal Night Splint Small (men 5-10 Women 5-9 1/2) can be helpful during the early stages of recovery.

If you are having Achilles pain or suffer from Achilles tendinosis a Graston, Active Release Techniques or soft tissue manipulation trained Chiropractor or therapist can be beneficial. Click here to see my rehab exercises for Achilles tendinosis.

Yours in health,

Dr. Justin Hildebrand

Manual Therapy

Reoccuring Muscle Injury?

Everyone deals with an injury at some point throughout life. Most will occur when adding a new activity to their routine (shoveling snow in the winter), doing something they should not (thinking they are 18 again), or trying to go to heavy to fast. These injuries will heal with RICE: Rest, Ice, Compression, and Elevation,  or with a few visits to their chiropractor.

What about the injuries that just seem to always come back, the ones that never completely go away? What causes reoccurring muscle strains or pulls? Why do we seem to always pull the same hamstring or strain the same shoulder? To answer this we need to look at how Active Release Techniques (ART) explains muscle injuries.

active_release_technique

When injuries occur the body lays down scar tissue to patch the site of injury. If enough time and care is given to the site than the body will replace this scar tissue with normal, fully functioning muscle tissue. If we continue to stretch, work, use or even eat inflammatory foods the scar tissue will thicken causing the muscles to become shorter and weaker since they can not contract as they should.

You can think of your muscles like roads. When a hole or divot occurs in a road, the city sends out a crew to patch it up. If it is aloud to dry and become part of the road than the road becomes smooth again. If more and more cars drive over the patch the more likely the patch will change shape and need more asphalt to fill the divot. Our muscles work in a similar way.thDHPAWTFS

When our muscles become short and weak tendons become stressed and tendinitis can set in. Range of motion of joints become decreased, strength is lost, and pain can increase and even occur in others areas. The cycle continues over and over, causing reoccurring chronic injuries.

How do we stop the cycle?

Myofascial release techniques like Active Release and Graston. These techniques help heal the tendons and muscles in pain and help eliminate the scar tissue that has developed causing the pain. So, if you have a recurring injury or next time you just pull a muscle find an ART or Graston specialist in your area and scrap the scar tissue before it really becomes a problem.

Yours in health,

Dr. Justin Hildebrand

Active Care Rehab

Squats, Not Kegels for Pelvic Floor Dysfunction

images6X49OM13Most pregnant women have probably been told they need to strengthen their pelvic floor and do their kegel exercises. Today I would like to share an article that shines a new thought on this concept. The author suggests that preforming a deep squat will actually lengthen and help women become aware of how to actually use their pelvic floor.

Stop Doing Kegels: Real Pelvic Floor Advice For Women (and Men)

It is important for all women (pregnant or not) and men to address the pelvic floor if pelvic pain is present. For more info on pregnancy related pain and treatment see my article and exercises.

Active Care Rehab

Suffering From Shin Splints?

thSuffering From Shin Splints?

If you are suffering from shin splints try this exercise (link above). This will help strengthen your Tibialis Anterior the main muscle on the front of your shin and the muscle responsible for flexing your foot (opposite of pointing your toes). For more info on shin splints see my article here.

Active Care Rehab

Lower Cross Syndrome and Anterior Hip

LCSLower cross syndrome is named for the crossing tightness and weakness that occurs in the lower back, core, and hip muscles.  In LCS, tightness of the low back muscles crosses with tightness of the iliopsoas (hip flexors) and rectus femoris (main quad muscle). Weakness of the deep abdominal muscles crosses with weakness of the gluteus maximus and medius.

This pattern of imbalance creates joint dysfunction, particularly in the lumbar spine, pelvis, hips, and knees. Specific postural changes seen in LCS include anterior pelvic tilt, increased lumbar curve, and knee straightening. Stress is increased on the low back and hips due to tight muscles and can cause pain in the low back when running, walking, and standing for long periods of time.

LCS is common in females, individuals that sit for most of the day and individuals that perform repetitive activities such as running and jumping. Many common injuries that plaques the active person can stem from LCS. Treatments for lower cross syndrome consist of postural training, Active Release/Graston on overactive muscles, and rehab exercises for underactive muscles. Additional home treatments for Lower Cross are foam rolling the quad and anterior hip muscles, Nature Made High Potency Magnesium 400 mg – 150 Liquid Softgels
for overactive and sore muscles, and anti-inflammatory nutrition for proper healing. Anti-inflammtory book.

Foam Roll

In Lower Cross Syndrome the anterior hip is chronically tight and lacks motion due to muscle overactivity and posture. If one can not move through the anterior hip, the low back has to become hypermobile or have too much motion. This can lead to low back pain and inhibition or weak core muscles.

The anterior hip consists of the large muscle of the quadriceps, Rectus Femoris, and the large hip flexor, Psoas. When these muscles become chronicalant hiply tight, the anterior hip capsule or ligaments begin to shorten. Now the hip can not translate or move through its proper range of motion and the gluts are put into a weakened, elongated state. The lumbar spine compensates by increasing its curve which causes the core muscles to weaken and shut off.

This process leads to overuse of the low back and pain, glut and core weakness, and hip impingements. If you have hip or low back pain, and/or Lower Cross Syndrome the click here to see this weeks exercises.

Yours in health

Dr. Justin Hildebrand

Active Care Rehab

Shin Splints and Ankle Injury Prevention

http://www.mdguidelines.com/shin-splints
http://www.mdguidelines.com/shin-splints

With the the new year approaching and many new years resolutions to be active, injury prevention should be on everyone’s mind. Many lower extremity conditions can develop through training, competition and overuse. Some common lower extremity conditions that plague the weekend warrior and even the avid runner are shin splints, plantar fasciitis, IT band syndrome, and various bursitis’.

These conditions commonly share biomechanical dysfunctions: weak foot intrinsic muscles, ankle instability, overactive calves, and weak glutes are just a few. Shin Splints, also known as medial tibial stress syndrome, result from too much force being placed on the shin and connective tissues that attach the muscles to the bone.  Symptoms are pain and tenderness along the inside of the shin during activity and at first generally calms down after exercise.  In chronic or long-standing cases, pain may persist after the activity.

Risk-factors for shin splints are tight calves, unstable ankles, weak anterior tibialis and having flat feet. Running on hard surfaces and participating in activities with sudden starts and stops may increase your risk for developing shin splints. Treatments for shin splints consist of stretching, Active Release and/or Graston, and functional rehabilitation of the feet, ankles and leg muscles. One can prevent this leg pain by choosing the correct shoe wear for their feet, cross training and varying their running surface. Strengthening insoles  can be helpful.

The ankle is a joint primarily made up of 3 bones and many ligaments. The muscles of the lower leg and feet act to stabilize the ankle along with their primary functions. When imbalances occur in these muscles ankle stability is lost and the chance of injury greatly increases. Commonly, the calf becomes overactive, weakening the anterior tibalis and changing the arches of the foot. Dorsiflexion or foot rising is lost causing the toe raising muscles to be recruited. These overactive muscles begin to produce extra stress on the shin. Over time stress pulls on the tibia leading to pain.

As the muscle imbalance grows the ankle becomes more unstable. The ankle ligaments are continuously stretched and pushed to their limits. At this point, ankle sprains and strains can occur. So if you are dealing with shin splints or “weak ankles,” click here to see exercises that maybe beneficial to you.

Yours in health,

Dr. Justin Hildebrand

Active Care Rehab, Manual Therapy

Shoulder Impingement and Rolled Shoulders

shoulder_impingement_intro01The shoulder joint consist of the shoulder blade, the humerus, and many muscles and ligaments. The key muscles are the rotator cuff (supraspinatous, infraspinatus, subscapularis, and teres minor), scapula stabilizers (serratus anterior and low-mid traps), and the pec muscles. When these muscles become imbalanced limitations and injury can persist.

Shoulder pain occurs in nearly ¼ of the general population and shoulder impingement is the most prevalent diagnosis in these cases. Shoulder impingement is also called supraspinatus syndrome, swimmer’s shoulder, and thrower’s shoulder and occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the joint. The rotator cuff muscles become compressed during movement and the body has to adjust to perform movements.

Symptoms of shoulder impingement are pain with raising arm from the side, weakness in lifting the arm, and loss of range of motion in the shoulder joint. This occurs due to incorrect repetitive motion and faulty posture. These faulty movements and postures tend to cause overuse of the pec muscles, levator scapulae, upper trap, and some of the supraspinatus.  At the same time, weakness of the mid and lower trap occurs. These imbalance leads to increased faulty movement patterns of the shoulder and injury occurs.

 (Photo: erikdalton.com)
(Photo: erikdalton.com)

In today’s society, rolled shoulders or forward shoulders are occurring more and more. This occurs due to computer/desk jobs and the fact that we sit for most of our day.

Commonly when the shoulder rolls forward the pec, upper trap and levator scap muscles become overactive. As a result the shoulder blade elevates and the arm rotates inward. This position places the shoulder stabilizers in a long, weak position. When imbalances occur in these muscles stability is lost and the chance of injury greatly increases.

As the imbalances and faulty posture continues, increased stress is placed on the shoulder, especially the supraspinatus. Due to the rolling and shoulder blade position the space the supraspinatus tendon runs through is lost and the tendon becomes impinged. Over time this compression leads to irritation and inflammation and pain follows.

Treatment for shoulder impingement consist of stretching, Active Release and/or Graston, and functional rehabilitation of the shoulder blade stabilizers, thoracic spine, and rotator cuff muscles. So if you are dealing with shoulder pain see this weeks exercises by clicking here.

Yours in Health,

Dr. Justin Hildebrand