Author Archives: scottdunham

Shin Splints – a pain in the leg

 

Injury:

Although commonly referred to as any pain in the lower leg, true shin splints are actually an inflammation of the muscle attachments to the tibia, also known as the shin bone  on the inside front of the lower leg. It is at this site that pain and tenderness will be felt by the runner. There are however other shin splint symptoms including possible swelling, lumps and bumps on the inside of the shin bone and redness of the shin.  Although initial pain in the shin may lessen over the course of an exercise, it will usually later return. 

A variety of factors either biomechanical or due to improper training may cause shin splints.  Running on hard surfaces, training with inadequate footwear, increasing training intensity to quickly, or having reduced ankle flexibility are all among the most common causes of shin splints.  Overpronation – the tendency of the feet to roll inwards too much- as well as oversupination –the tendency of the feet roll outwards too much – are both other major causes of shin splints.

 

Prevention and Treatment:

The cause of the injury must be treated to prevent the injury from recurring.  Insoles, orthotics, and proper running shoes can improve biomechanical causative factors, such as overpronation or oversupination.  Running shoes must provide enough cushioning and shock absorption for the runner.   To avoid overworked muscles, training distances should not be increased by more than 10% per week.  Softer surfaces, such as grass or sand, should be run on as much as possible as they provide better shock absorption for the runner than do harder surfaces.  Reducing the impact on the shins will make you less susceptible to injury.  Stretching regularly is advisable in order to maintain muscle flexibility also reducing the chance of injury.  Lastly, simply taking a break from running following periods of intense training can give the body a chance to recuperate and prevent injury.

 

Treatment of shin splints involves reducing inflammation and pain, addressing biomechanical or training causative factors, restoring muscles to their original condition, and finally returning to training in a safe and gradual manner.  Runners should rest and allow their injury to heal.  To reduce initial pain and inflammation, ice or cold therapy should be applied.  Calf supports and heat retainers will reduce strain on the muscles by providing compression to the lower leg. By using a calf support to retain body heat, blood vessels will be dilated and there will be an increase in blood flow to the tissues.  More blood to an injured area means the area will receive more nutrients and will therefore heal more quickly. Fitness should be maintained with low impact and non weight bearing exercises such as swimming, cycling or running in water. Additional support is available at sports injury clinics.  Anti-inflammatory medication may be prescribed, the shin may be taped to reduce pressure on the muscles attached to the shin, gait analysis may be performed to accurately determine if overpronation or oversupination are causative factors, and massage therapy may also be provided. 

 

All parts of the human body are connected, and work together to allow one to perform.  It is important to realize that because all systems and parts of our bodies rely on each other, an injury to one area of the body will often affect another area.  It is for this reason the root of an injury such as shin splints may be elsewhere in the body than at the site of pain.  Shin splints are sometimes less of an injury than they are a symptom of another injury along the human kinetic chain. Sports injury therapists are trained to recognize and understand the relationships between all parts of the human body.  When treating injuries such as shin splints, the sports therapist should look above and below the injury. In the case of shin splints, sports therapists may look above the shin to the thigh and hip, as well as below the shin to the feet.  Much like a detective, the sports therapist must work to find the root of the injury.  Until the true cause of the injury is identified and treated, all other forms of treatment are quite analogous to band aids – temporary relief.

 

If you are suffering from shin splints or wish to have your gait analyzed for prevention of running injuries, contact the health professionals at Kew Gardens Health Group.

 

Written by Megan Meisner

Core Stability Pics

Here are some pictures demonstrating some of the most common core stability exercises.  Many thanks to members of the Ontario Blues Mens Rugby Team!

 

Blues Manager Mark Winokur demonstrates a plank

Blues Manager Mark Winokur demonstrates a plank

Shawn Windsor demonstrates a side bridge

Shawn Windsor demonstrates a side bridge

Doug Wooldridge demonstrates a cross crawl

Doug Wooldridge demonstrates a cross crawl

Mark Macsween and Keegan Selby demonstrate a partner-assisted plank

Mark Macsween and Keegan Selby demonstrate a partner-assisted plank

For more information on Core stability, check out the article here.  Information for the Ontario Blues Rugby team can be found at www.rugbyontario.com

Death of the sit-up

Sit-ups used to be the go to exercise for getting that tight, toned midsection and rock hard 6-pack abs.  Athletes did them, fitness buffs advocated them, even doctors prescribed them to their couch-potato patients who wanted to lose inches and get that David Hasselhoff-like body.

 

And somewhere between the Hoff prancing down the beach on the set of Baywatch and the infomercial-driven world of closet-clogging exercise equipment, the sit-up developed a bad reputation.  Exercise science started to come out with studies indicating that the stress and strain put on the body while doing a sit-up could actually be harming the individual and leading to further injury in the future.  Statistics also started to arise that injury was not necessarily prevented with a six-pack type physique, but rather was dependent upon the balanced strength of an individual’s core.

 

The anatomical “core” is a complex of muscles which encircles the abdomen.  They are composed of your low back muscles, your abdominal muscles (six-pack abs) as well as muscles which encircle your entire mid-section called the transverse abdominis (TA).  It turns out that those who suffer back injuries have poor recruitment of both the small muscles in their lower back as well as the transverse abdominis. 

 

Core-training has also been well publicized and has lead to another wave of inventions and training systems flooding the Infomercial market on late-night TV.  The most common reserach-supported exercises to help strengthen the core include the plank, side bridge and the “bird-dog”.  Pictures of these exercises can be seen here.

 

If you have any questions regarding proper core training or beginning an exercise program, please contact the health professionals at Kew Gardens Health Group.

Paddling Injury Treatment

Traditional methods of treatment, such as rest, ice, ultrasound, anti-inflammatory medications, muscle stimulation, steroid injections, and surgery, are generally ineffective. While these methods may address the symptoms of the injury, they do not fix its cause.  Consequently, they will often only provide temporary relief. Because these methods take a  long time to begin providing the patient with relief, they are not ideal for paddlers who would like to or have obligations to begin training again.

 

 A combination of ART (Active Release Technique) and stretching and ice is the best remedy for paddling injuries. The Active Release Technique addresses and corrects problems in the soft tissues of the body – such as muscles, fascia, and nerves- and associated problems in the kinetic chain. This hands-on treatment is very effective for paddling injuries, as it can locate and treat scar tissue adhesions.  This allows adhesions to be broken up, tissue flexibility and movement to be regained, and flexibility and balance to be restored.

 

 ART is essentially an intensive massage.  The injured muscle, ligament, or tendon is tightened, and the patient will then actively stretch the tissue. As the tissue is stretched, the practitioner will apply a certain amount of pressure to the area. The muscle’s tension and texture can be assessed, to identify scar tissue. The amount and direction of applied pressure will depend on the injury, and can be modified to treat the specific problem. ART is a fast and effective method of treatment, and this is why it is recommended for paddling injuries.

 

For a full comprehensive assessment and treatment of any of your repetitive type injuries, contact Kew Gardens Health Group at 416 907-0103.

 

Written by Megan Meisner

Paddling Injuries – Intro

Paddling involves the repetition of certain movements and strokes. Although acute injury- the injury that results from sudden trauma – is uncommon among paddling athletes, repetitive injury is very common. This is because of the repetitive motions the athlete must perform when training or racing.  At the end of a training season, paddlers may have taken several hundred stokes.

 Not only can the repetitive motion of paddling be damaging, but the motions themselves may cause injury. The force exerted by the athlete onto the water causes a reaction force from the water to be transferred back through the athlete’s body, to ultimately shoot the boat forward. It is this reactant force, affecting numerous muscles and joints throughout the body, that is the cause of many injuries. Common sites of injury in paddling athletes are the hip, back, shoulder, and forearm. The integrated manner, in which the muscles and joints of the athlete must work while paddling, is known as the “kinetic chain”.

 Sometimes, the underlying cause of injury lies not in the actions of paddling, but in the athletes themselves.  In response to problems with strength, flexibility or balance in muscles or joints, the body will try to compensate. These “movement compensations” are generally inefficient and can be damaging. Although these “movement compensations” do not usually cause problems in the demands of everyday activities, they cause the athlete great problems while paddling. The forces associated with each stroke can not properly be controlled by an athlete with “movement compensations”, and consequently, the athlete moves inefficiently. Additionally, the force of each stroke is not evenly received throughout the body, as it is usually concentrated on the area of the “movement compensation”.

 It is possible that by attempting to repair itself, the body can in fact worsen an injury. Over time, strains that result from paddling can develop into what is called micro-trauma. The body will build up scar tissue as it attempts to heal what may initially be painless strains. However, as time goes on, the body develops new strains, which in turn cause the body to build up more scar tissue. When enough scar tissue is accumulated, it negatively impacts the health and function of the muscles. Built up scar tissue at this stage is referred to as an “adhesion”. Muscles must work against the adhesions, which consequently causes additional strain.  Adhesions may also reduce blood flow, restrict joint motion, or cause pain, tightness, and stiffness. This repetitive cycle of micro-trauma and adhesions, may over time turn into an acute injury, as stain builds.

It is therefore critical that the human kinetic chain be in good condition. If an athlete has sufficient flexibility, strength, and muscle balance, they will be much less susceptible to injury.  It is wise to address these issues before they start negatively impacting your performance and lead to injury which keeps you out of action.

written by:  Megan Meisner

Osteoporosis common questions

What is osteoporosis?

Osteoporosis is a decrease in bone mass and density and an increased risk of fracture.

 What causes osteoporosis?

 There is no single cause of osteoporosis.

 Our bodies constantly build new bone and remove older bone. In childhood, more bone is built than removed, and so the bones grow in size. After age 30 or 40, the cells that build new bone do not keep up with those that remove bone. The total amount of bone then decreases, and osteoporosis may develop as a result.

 Are women more affected than men?

The average rate of bone loss in men and in women who have not yet reached menopause is small.  But after menopause, bone loss in women accelerates to an average of one to two percent a year.

 This is because after menopause the level of the female hormone estrogen sharply decreases.  Estrogen protects the skeleton by helping the body’s bone-forming cells to keep working.  After menopause, when the level decreases, some of this protection is lost.

 How can I prevent Osteoporosis?

A combined approach of nutrition and exercise can help prevent the onset of osteoporosis.  Adequate Calcium and Vitamin D helps keep the bones strong to withstand everyday forces.  1000 mg of Calcium and 400 IU of Vitamin D are recommended daily for women, through both food and supplement sources.

Exercise is also extremely important in preventing the onset of osteoporosis.  Regular weight-bearing activity puts stress through the bones, and they react much like muscles do by becoming stronger through use.

 

It is important to consult with a health professional before beginning any new exercise program or adding supplementation to your diet.  Contact the professionals at Kew Gardens Health Group for more information.

Congratulations Norma Wilkie!

Congratulations to Kew Gardens Health Group Osteopath Norma Wilkie who competed in the “Head of the Trent” regatta this past weekend.  Her boat placed first in the Women’s 8s division!  A youtube video of the race can be seen at:  http://www.youtube.com/watch?v=XobzM1WYO4g

Congratulations Norma on your achievement, and good luck in future races!

Back-Pack Safety

With September rolling around and the kids going back to school, now is a good time to review some simple tips for Back-Pack Safety

 

1)  Encourage children to utilize both straps when carrying a backpack

2)  Make sure to adjust the straps properly to ensure proper distribution of weight

3)  Pack the heavier items at the bottom of the bag for better distribution

4)  Maximum load should be less than 10% of the child’s weight

 

If you follow these guidelines, you can ensure that your child is safe when returning to school!

For more details on the Ontario Chiropractic Association’s “Pack it Light, Wear it Right” campaign, visit them at:  www.chiropractic.on.ca

Congratulations!!!

A big heart-felt congratulations goes out to Kew Gardens Health Group patients Andrea Mierzynski, Jane Weninger and Daria Nardone.  On September 12th and 13th they participated in the 60km walk to end breast Cancer.  As part of their team “Breast ov Beach” they raised over $20,000 for the Princess Margaret Hospital to support Breast Cancer Research.

Kew Gardens Health Group would like to congratulate them on their achievement and for raising funds for this very worthy cause.

 You can check out their website at:  

http://www.endcancer.ca/site/TR/Events/Toronto2009?px=2862588&pg=personal&fr_id=1323

 

Breast ov Beach

Stretching – Does it increase performance?

Our second BLOG about stretching looks at the assertion that stretching before competition will increase performance.

A common claim was that stretching immediately before competition would increase your performance.  A 2004 literature review found 21 studies which looked at performance and stretching prior to competition.  20 of the 21 studies actually found a DECREASE in performance if stretching is done prior to the activity with 1 study finding mixed results.  These studies involved jumping, lifting or throwing types of activities.  The reason for these findings is that stretching puts your muscles into a temporarily lengthened state that is not well equipped for maximum contraction.

So if stretching before activity does not prevent injuries and can actually decrease performance – What is a better alternative?  A study conducted in 2004 involving rugby players demonstrated that dynamic stretching (quick stretching through a range of motion) produced significantly faster 20 meter sprint times than static stretching or no stretching at all.    A follow-up study looked at combining dynamic and static stretching (slow, methodical stretch and hold) and revealed that static stretching could actually undo the effects of dynamic stretching, making the athletes slower, and less powerful.

The success of dynamic stretching is due to preparing the athlete for competition by mimicking the movements they will have to perform on the field of play.  Especially at the higher levels, the emphasis now is on general body warm-up and dynamic stretching to prepare the athletes for competition.  Warm-ups which mimic game-like situations will help prepare the athletes mentally for competition, and dynamic stretching will best prepare the body for the situations one will encounter during the course of play. 

The take home message is that statically stretching immediately before competition may actually hinder performance.  Getting away from slow stretching and towards quicker stretching techniques will help your athletes to avoid injury and perform at their very best. 

In good health,

Dr. Scott Dunham

References

  1. Does Stretching Increase Performance? Clinical Journal of Sports Medicine, Sept 2004, Shrier, Ian
  2. The effect of different warm-up stretch protocols on 20 meter sprint performance in trained rugby union players. Journal Of Strength And Conditioning Research / National Strength & Conditioning Association 2004 Nov; Vol. 18 (4), pp. 885-8.
  3. The acute effects of combined static and dynamic stretch protocols on fifty-meter sprint performance in track-and-field athletes. Journal Of Strength And Conditioning Research / National Strength & Conditioning Association 2007 Aug; Vol. 21 (3), pp. 784-7.
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