Active Care Rehab

Winter Conditioning and Proper Breathing

tredmillWith Midwest winter weather upon us, many people will be transitioning to more indoor workouts and training. One downfall to being active is that the weather does not always allow us to get our activity in year round. If you are a competitive runner, a weekend warrior or a person that enjoys a nice walk or bike ride through the neighborhood the snow and cold can keep you inside and bundled up.

Although a nice warm cup of hot chocolate or hard cider sounds cozy on a frigid winter day, we still have to find ways to keep our bodies healthy and in shape. Many choose alternatives to being outside and exercising such as running or walking on a treadmill and riding a stationary bike. These great pieces of exercise equipment help keep ones cardiovascular system in shape but can lead to injuries when heading back to the road or trail when the weather allows.

Using a treadmill or stationary bike does not engage the glute and ankle muscles like their road counterparts. While your endurance may not decline during the winter months, one’s hip and ankle stability generally does. It becomes more important to start a core/glute and ankle strengthening program and working on generally flexibility so that when your competitive season begins or take to the outdoors again you are ready for action.

When working on core strengthening it is important to also include breathing techniques. Improper respiration can aid in many dysfunctions and the development in pain. Many of us hold our stomachs tight to appear to be smaller than we are. Doing this blocks the diaphragm and does not let it push downward when we inhale. This decreases the strength of the protective muscles of the spine and hips.

When the diaphragm can not fall properly, other muscles have to assist in rib expansion. The neck and shoulder muscles pull the ribs upward, instead of them moving downward and out. This type of respiration can lead to shoulder and neck pain along with headaches. The lower extremity muscles than have too help stabilize the spine instead of the hips or pelvis. This shift in stability can increase to the risk to many injuries.

Long term improper breathing can lead to overuse injuries and syndromes in the spine and extremities. Over using the neck and shoulder muscles can cause tendinitis in the shoulder and below, nerve entrapments that mimic carpal tunnel, and disc injuries in the spine.

Click here see exercises that help correct your breathing.

Your in health,

Dr. Justin Hildebrand


Tired of Taking NSAIDS?

The amount of over-the-counter non-steroidal anti-inflammatory drugs and prescribed anti-inflammatory medications taken in the United States is continually increasing every day. So much so that kidney problems have climbed higher due to these drugs. According to “an increased risk of acute kidney injury within 30 days of NSAID initiation was noted” the study also found a correlation between hospitalizations with a diagnosis of acute kidney injury with the initiation of NSAIDS.  What else can you do?

Most people do not realize that many diseases and ailments are caused or promoted by inflammation. Anti-inflammatory nutrition is very effective in decreasing chronic pain. It can be used to help control headaches, neck and back pain, general muscle and joint soreness and conditions such as osteoarthritis, rheumatoid arthritis, acne, syndrome X, diabetes, heart disease, and peripheral vascular disease. For a larger list of inflammatory conditions see

So what is anti-inflammatory nutrition? Anti-inflammatory nutrition is incorporating foods into ones diet that have anti-inflammatory properties. By adding these foods and limiting inflammatory foods one can decrease the inflammatory process in their body and therefore decreased the aches and pains associated. Yes, the inflammatory process is important in healing but if one is dealing with the conditions or issues above than they are experiencing chronic inflammation.

To incorporate an anti-inflammatory diet one must first know what foods are inflammatory. All grains and grain products, trans fats, soda’s, sugar, and almost all packaged foods. These foods make up the majority of the classic American diet. To decrease inflammation one does not have to cut out all grains but one must ingest more anti-inflammatory food than inflammatory foods. Anti-inflammatory foods are fruits and vegetables, many types of fish, grass fed meats, omega 3s, raw nuts, dark chocolate, and spices such as turmeric, garlic, and ginger. For a larger list of inflammatory and anti-inflammatory foods see

One must ask themselves how much inflammation do I want, when planning meals. Instead of spaghetti with meat sauce, you can cook gluten free noodles or spaghetti squash and add sautéed onions, garlic, and sweet peppers to a lean meat sauce. Instead of buying HIGH inflammatory dressings at your local store try making your own with extra virgin olive oil, balsamic vinegar (or lemon juice), mustard if you like, and spices (Greek, Italian, ginger, dill, oregano) to taste. Choose snacks such as fruit smoothies, raw nuts or dark chocolate and skip the soda and have water or green tea. When have a drink choose red wine or gluten free or stout beer.

Breakfast: Try omega-3 eggs with sautéed potatoes and veggies, granola with fruit and yogurt or almond milk.

Lunch/Dinner: Chicken salads with homemade dressing, lean steak with sautéed potatoes, or pizza with gluten free crust, fresh tomatoes and your favorite vegetable toppings.

This type of lifestyle change seems tough at first but there are many anti-inflammatory foods available and many good cook books to help you along your way. For guidlines to start your anti-inflammatory lifestyle click here.

Yours in health,

Dr. Justin Hildebrand

Manual Therapy

What High Heels Do To Your Posture

High heels may be pretty or spectacular to some but let’s look at what they do to your posture. First and the most obvious is that they point the toes causing constant contraction of the calves. This places the plantar fascia in a shortened state and causes the feet to become stiff and tight. Contraction of the calves places strain on the knees and weakens the shin muscles, predisposing one to shin splints.

Due to the changes in the foot position and tightening of the calves, the hip flexers and quads have to contract to keep the body’s center of gravity neutral. This pulls the lower back into extension or into anterior pelvic tilt, giving the illusion of full rear end.  The new position of the lower back disrupts breathing, tightens the back muscles and weakens the glute muscles, predisposing one to lower back and hip pain.

With the buttocks pushed back and the pelvis tilted forward, the mid back has to round out for balance. The shoulders begin to round with the mid back and the head shifts forward realigning itself over the body. The neck muscles tighten predisposing one to shoulder and neck pain along with headaches.

All of these changes occur due to wearing high heels. The center of gravity is changed completely stressing not just the spine but many of the joints throughout the body. All of this occurs just because you wanted to wear those pretty little heels.

Counteracting the effects of wearing high heels is not as simple as taking them off. The effects they have on the body cause long term changes in posture and center of gravity. We suggest 5 activities to start the counteracting measures necessary for high heel wear.

1. Self Myofascial Release-Foam rolling or using a ball to release your own plantar fascia, calves, hip flexors, and thoracic spine can help lengthen the muscles and mobilize the joints that are most effected.

2. Activate Weakened Muscles-Glute, core and breathing exercises are essential in reversing the compensating factors that occur with high heel wear.

3. Increase Ankle/Foot Mobility-Your feet need to move to function correctly. Increasing mobility will increase the proper function of your feet.

4. Retrain Center of Gravity-Exercises like squats and hip hinging will help push your center of gravity backwards were it belongs.

5. Stop Wearing High Heels-The most important and most logical way to counteract the negative effects of wearing high heels.

See exercises by clicking here to get started.

Yours in health,

Dr. Justin Hildebrand

Active Care Rehab, Manual Therapy

Are you considering expanding your family?

According to the Baby Center, the most births in the United States are in the months of July, August, and September. This means that planning and discussion is well underway. Mother’s consider finances, work schedules, family life, and much more in decision and plans but they forget about one important thing, Their Bodies. We must consider the whole picture.

Is your body ready for pregnancy? Anywhere from 50%-80% of woman report having low back or pelvic pain during their pregnancy and 68% continue to have pain post pregnancy. Many of these women could have decreased this pain if they would have prepared their bodies pre or during pregnancy.

What changes occur in pregnancy that increases your chance of experiencing pain? A women’s body goes through many changes in pregnancy but only a specific few are related to pain. One’s abdominal muscles are stretched to their limit, muscle and ligament strength decreases, joint hypermobility occurs (postural changes), and the pelvic floor becomes strained. If these conditions are thought of pre or in early pregnancy, the pain related to pregnancy could be decreased and post-partum pain may be controlled.

How can I prepare my body? It is important to get your body in shape, this is not a strenuous exercise program but a functional rehab program that is simple and is not time consuming. These types of exercises will help decrease the muscle imbalance and weaknesses that occur during pregnancy. Check out the pregnancy exercises.

Manual therapies such as Active Release and Graston can help remove any adhesions or scar tissue that builds up and aid in pain reduction. If you are interested in learning more about reducing pain during pregnancy contact me and/or find a chiropractor/manual therapist that specializes in pregnancy or rehabilitation. See the pictures below for examples of ART on the pelvic ligaments.


ART starting Position

ART Finishing Position


Remember it is important to plan ahead but women do not forget about your bodies.

Yours in health,

Dr. Justin Hildebrand