Treat your stress fracture/reaction

1. Prevention

a. Get rid of worn out shoes
b. Do you overpronate seek someone with experience to help you
c. Sudden increases in intensity or frequency of training
d. Over training
e. Poor biomechanics
f. Absence of menstrual cycle results in loss of bone mass
g. Restrictive diets
h. Muscle weakness or muscle imbalances

2. Training

a. Limit training to non-impact for 8 to 17 weeks
b. Gradually increase the frequency and intensity of activity over time
c. Focus on quality and not quantity
d. Do not train when tired

3. Increase your bone health
Note: Your bone can only make deposits of calcium along with other minerals until the age of 25. After 25, it is recommended that you take daily calcium supplements.

Stress Fractures/ Stress Reaction

The most common overuse injuries. Stress fractures are caused by repetitive activity such as running, dancing, basketball to name a few. These fractures are usually stable; and therefore, treatment is often only activity restriction.

Symptoms:
* Swelling
* Tenderness
* Pain

Walking is uncomfortable, but running and jumping are worse. The pain is deep ache and is localized anterior and posterior over the bone.

Most commonly seen:
* Metatarsals of the foot
* Bones in the ankle, shins [tibia], knees, and hips [neck of the femur]

Next month learn how to treat a stress fracture

Core stability

Core stablility is essential to maximize performance and prevent injury.

What makes up the core:
* Multifidus - Deep muscle which starts at the neck and ends in the low back
* Interspinales, Intertransversarii, Rotatores - Deep muscles which attatch to the spine
*Internal/External Oblique & Transverse abdominus - increase interthorasis pressure = stabilize the spine
* Paraspinal [Erector Spinae] - help to balance all forced involved when you flex your spine
* Quadratus lumborum - stabilizes the back
* Thoracolumbar fascia

All of these muscles help you stabilize the spine, pelvis and shoulders to provide support and stability.

Imbalances can weaken your core

Imbalances affect performance and can lead to injury or a decrease in your performance

Adhesions in any part of the kinetic chain can affect your performance and cause injury.
* Restrict motion
* Reduces circulation
* Inhibits nerve function

If not treated these adhesions causes more friction and pressure on the tissue which results in the production of more collegen and adhesions within the injured tissue

Exercise alone may not correct these imbalances

Exercises you may use to correct and strengthen the core
* Physioball exercises {bridge, bird dog, crunches]
* wobble boards to improve proprioception
* back extension

Why do they not help? You are not addressing the most important issue - soft tissue adhesions that formed due to the muscle imbalances

* Soft tissue adhesions along with repetitive motion causes the body to lay down more restrictive tissue which causes muscles, ligaments, tendons, fascia, nerves to stick together.

To fix the problem you must remove the soft tissue restriction first and then strengthen the muscles

Inflammation ? What can you do?

• Increase consumption of anti-inflammatory food

- Cold water fish [i.e. salmon, mackerel]

- Flax seed oil [1tbsp/day]

- Ginger 2-4 grams of dried or 20 grams of fresh

- Olive oil

- Grapes

- Blueberries

- Tea

• Avoid foods which increase inflammation

- White past

- Breads

- Bagels

- Cookies

- Muffins

- Cakes

- Crackers

• Sleep [lack of sleep may stimulate an increase in chronic inflammatory response]
• Avoid Omega-6 oils

- Safflower, Sunflower, corn, syobean.

- Potatos, tomatos and eggplant

• Drink in moderation [Drinking alcohol reduces inflammation]
• Take Vitamin C & E [antioxidants supress inflammation]
• Stress increases inflammation [ Stress increases Cortisol in your body. When your body is in a state of inflammation your adrenal glands put out high levels of cortisol. Cortisol also increases insulin resistance which will cause you to gain weight and more inflammation. It also decreases your immune system and nervous system]
• Use Olive Oil [has similar properties to Ibuprofen in its ability to decrease inflammation]

Herniated Disk?

Can cause nerve compression syndrome that can be difficult and be painful and difficult to manage.





Symptoms

• mild tingling



• dull ache



• burning sensation



• severe pain which is enough that you are unable to move

Low back

• painful with movement of low back



• sharp pain, numbness and muscle weakness and pain in one leg, hip or gluteals

Neck

• painful with movement of neck



• pain that radiates to the shoulder blade, arm, forearm or fingers



• numbness and weakness to your from your shoulder to the fingers

Onset is gradual and usually have a history of low back and neck pain which gets worse. The majority of cases caused by the nerve compression do not require surgery or medication to heal. But, you still need to watch for red flags. These red flags require immediate medical attention:

• Loss of bowl and bladder



• Loss of sensation to buttocks and perineum



• Trauma or fall with severe pain



• Loss of sensation and muscle weakness

Most cases can be treated with manual therapy [ART, Manipulation], decompression therapy, lifestyle changes and exercises [McKenzie protocol for disc]

Plantar Fascitis

Inflammation of the plantar fascia hurts! When the connective tissue that runs from your heel to your toes gets irritated, it swells and can become painful. Sometimes bone spurs can form on your heel. If you receive the proper treatment for plantar fascitis, you can heal this injury. Some of the causes of plantar fascitis have to do with your foot structure or gait or other tissues like a tight Achilles Tendon. When you walk you pronate and supinate the foot.

• Slap the ground or push off?


• Your foot absorbs the shock of your motion


• This force goes right into the bottom of the foot

Conventional therapy may involve rest, steroid injection and usually requires six weeks to 3 months to heal. Surgery can take even longer.

ART and Graston have shown complete resolution of the plantar fascitis symptoms in 90% of cases. With marked improvement in just one to three treatments. I have seen great results even with patients who have developed chronic plantar fascitis.

ART and Graston protocols work on the foot muscles that become affected by the injury. The muscles that help the foot flex such as the Flexor digitorum Brevis muscle, and the Quadratus Plantae muscle are often involved. They run very deep within the foot and seem to respond to the deep tissue release abilities of these techniques.

1. Structures Involved

• Gastrocnemius/Soleus


• Tibialis Posterior


• Flexor digitorum longus


• Flexor hallucis longus muscle

Any alteration in these muscles will affect the way you pronate and supinate your foot.

2. Repetitive motion

• Worn out shoes?


• structure stressed = inflammation = cross fiber adhesions = friction syndrome = scar tissue formation

3. Follow up with Exercises

• Stretch Gastronemius, Soleus, Tibialis anterior, Hamstrings


• Walk on your toes and heels with feet straight, out and in for 20-30 times


• Calf raises 20-30 times

Active Release Technique

This technique was developed by a Chiropractor Dr Michael Leahy, of Colorado Springs, Colorado.

Essentially, ART is a hands-on soft-tissue technique that can simultaneously locate and break up scar tissue. The power of ART lies in how it combines patient motion with practitioner techniques to release the adhesion's between tissue layers. This process

* restores mobility and relative motion to the soft tissue layers

*increases circulatory function, and

* increases neurological function by breaking restrictive adhesion's.

Effectiveness of Active Release Techniques

There are people who say they are ART certified but are not. So, take the time to check out the certification levels of your ART doctor. ART offers many courses:

• Upper extremity
• Lower extremity
• Spine
• Long nerve entrapment's
• Biomechanics
• Master classes
  

Great book I recommend is "Release Your Pain" by Dr Abelson, DC. Would recommend this!