Preventing Common Lower Leg Injuries

Preventing Common Lower Leg Injuries through Preventative Strengthening Exercises:

                As the Fox Cities Marathon draws near, your training program intensity is beginning to peak.  Longer training runs may cause overuse injuries from cumulative stress on your lower leg tissues.  Overuse injuries that are typical in the lower leg include hip strain,  IT band syndrome, inner and outer meniscus (cushion between the knees) swelling, inner knee ligament soreness, kneecap tracking problems, soft tissue pain and strain on the front or side of the shin bone, foot  and inner arch pain, Achilles tendon strain, and plantar fascia inflammation, pain, and thickening.  A common breakdown in alignment of the lower leg due to weakness in specific muscles leads to many of the overuse injuries indicated above. 

                A good test to see if one’s lower leg alignment is normal is to perform a single leg squat in front of a full-length mirror.  If your hips are not level or if your knee caves inward of your second toe, then your muscles are probably not maintaining proper alignment.  This may suggest your outer hip stabilizing muscles are weak or fatigued.  If you see your foot arch falling during a single leg squat, then your front shin muscles are likely weak or fatigued.  Another common finding is that your knee may extend forward beyond your toes, which commonly suggests weakness and tightness in the posterior gluteal region. 

                See the following YouTube links for exercises to counteract these muscle weaknesses, improve your lower leg stability and alignment, and to prevent and stay injury free.  Try to perform the exercises below for 2-3 sets, 10 repetitions per set, 3-4 times per week for a minimum of 12 weeks .  Good luck everyone as you train and race this fall! 

Shin strengthening video             Hip strengthening video

              Buttock Strengthening video

About the author of this article:

                Dr. Nathan Zachor, DC is a chiropractic provider at Schubbe Resch Chiropractic and Physical Therapy in Appleton.  He is board certified in both functional rehabilitation and chiropractic.  Dr. Zachor is certified in multiple soft tissue techniques to treat athletic injuries including Active Release Technique (ART), Graston Technique (GT), Kinesiotaping Technique (CKTP), and Cold Laser Therapy.  He may be reached at Nathan.zachor@schubbeappleton.com or 920-738-0200 for any additional questions or concerns you may have related to the content of the above article.

Even Chiropractors Have Training Pain!

Going through pregnancy, labor and raising a 1 year old son made it difficult to find not only the time, but the energy for a one of my passions, running. It took setting a goal of completing the Cellcom Green Bay Half Marathon in May to get me back to lacing up my shoes and hitting the pavement! 

 

I am among many who set lofty goals for themselves and jump right into training.  Whether it's a full marathon or 5K you aspire to complete, injuries can crop up and prevent you from crossing the finish line.  Running injuries are most commonly caused by overuse... too much, too fast, too soon.  They hit both beginners as well as those more experienced.  Being a chiropractor, I was not immune to minor aches and pains from training and was chronically dealing with an achy hip after long runs.  The longer distances were becoming difficult and sometimes not even possible.  After getting adjusted and doing corrective pelvic stabilizing exercises the hip pain is improved and is no longer preventing me from going the distance.   

 

Getting early treatment is by far the best option in order to get back to training asap.  Most running injuries can be prevented.  Here at Schubbe Resch Chiropractic & Physical Therapy Centers we work to keep your body functioning to its best capacity and keep you doing the things to you love!

Common Marathon Training Injuries and Their Treatments - By Dr. John Schubbe and Kari Resch P.T.

The training for and actual running of a marathon puts a lot of stress on your body.  Although many people are able to complete these activities with few or no injuries, not everyone is so lucky. We’ve listed the most common injuries below and the treatments we would recommend at our offices.

Active Release Technique

Achilles Tendonitis is an inflammation of the Achilles tendon.  It is one of the more common injuries for the runner, and in most cases is caused by excessive training over an extended period of time.

Recommended Treatment –  Achilles Tendonitis can be treated with calf/Achilles stretching, rest, ice, supportive shoe wear, Kinesio Taping, Graston Technique , orthotics, Balance training, ankle/hip strengthening, and ice massage.

Chondromalcia or Runner’s Knee is a running injury where the cartilage underneath the kneecap starts to soften and break down.

Recommended Treatment –We start by addressing strength deficits and flexibility of the hip and thigh musculature.  It is best at first to avoid high impact exercise as well as kneeling and squatting.  Icing is recommended along with low resistance exercise such as stationary bicycling, pool running, or swimming (flutter kick).  Evaluation of foot wear is essential, and a patellar tracking brace is often helpful.  Finally strengthening and stretching of the quadriceps and hamstring muscle groups is critical for an effective and lasting rehabilitation of chondral malacia patella. Kinesio Taping can also provide relief.

Plantar Fasciitis is an inflammation of the plantar fascia – a thick, fibrous band that runs along the bottom of the foot.  Inflammation can be caused by direct injury or by repeated trauma.

Recommended Treatment – Typical treatment of plantar fasciitis includes calf/Achilles stretching, arch stretching/strengthening, orthotics, Graston Technique, Kinesio Taping, Ultrasound, ankle/hip strengthening, balance training, and ice massage

Iliotibial Band Syndrome The IT Band is a thick tendon that runs down the outside of the thigh and inserts just below the knee.  When the IT Band becomes tight, it pulls the knee joint out of alignment which results in inflammation and pain.

Recommended Treatment – Iliotibial band syndrome is most accurately treated by addressing strength and flexibility imbalances.  We evaluate training errors, improper foot wear, hyperpronation, muscle imbalances and lack of flexibility.  The main focus of this rehabilitation and prevention should be increasing the elasticity of the iliotibial band and restoring the strength of the gluteus medius muscle.  Stretching is usually prescribed, but the IT band, as well as the deep lateral rotators of the hip should be loosened up by deep tissue massage.

Shin Splints is a specific condition called Medial Tibial Stress Syndrome (MTSS). When the muscles that are attached to the tibia and fibula bones are overworked, they pull on the bones and cause pain.

Recommended Treatment – Shin splints can be treated using supportive shoe wear, orthotics, Kinesio Taping, rest, hip/ankle strengthening, balance training, and ice massage.

Any of the above injuries can be treated by one of our chiropractors or physical therapists, or a combination of the two.  Call one of our offices to schedule an appointment to keep you running strong!

Dr. Nathan Zachor Receives ART Certification

If you are an athlete who is looking for an Active Release Technique (ART) certified provider to treat your soft tissue injuries, please contact Schubbe Resch Chiropractic and Physical Therapy of Appleton at 920-738-0200.  Dr. Nathan Zachor, DC became ART certified in the lower extremity (leg) in Chicago, IL as of July 1st.  ART is the gold standard in soft tissue treatment.  We are excited to continue to deliver the latest techniques to help our community members and patients return to work, sports, and daily activities faster.

ART is the perfect technique to consider if you are dealing with running injuries, for example during your training for the Fox Cities Marathon!  Watch our blog, facebook page, and tweets for more information about future workshops and events we are offering marathon participants.

Plantar Fasciitis

Plantar fasciitis is an inflammation caused by excessive stretching of the plantar fascia (the tissue that extends the entire length of the bottom of the foot).  Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort. Plantar tendonosis is an adhesion or thickening in the plantar fascia caused by repetitive micro tears in the plantar fascia.

Plantar fasciitis or tendonosis may be caused by the following:

• Additional or excessive weight on the foot
• Wearing shoes without any arch support or proper arch support
• A foot with an unusually high arch
• A sudden increase in physical activity

Symptoms usually consist of pain near the inside of the foot where the heel and arch meet.  The pain is often worse first thing in the morning, or after a rest, because the plantar fascia contracts back to its original shape when you are resting.  As the day progresses and the plantar fascia stretches, the pain often subsides or significantly reduces.

The key for proper treatment of plantar fasciitis or tendonosis is determining what is causing the excessive strain and stretching of the plantar fasciitis.  Often changing your footwear is the first step towards recovery.  You can also follow these recommendations:

• Don't go barefoot
• Stretch your foot before getting out of bed or before standing .
• Ice your heels (or the painful area) 2-3 times a day to reduce inflammation
• Maintain a healthy weight
• Avoid running on hard or uneven ground.
• Wear shoes with proper arch support and shock absorption
• If none of the above tips work, see our clinicians for evaluation using Graston Technique or Active Release Technique to assess whether the heel or arch pain is related to a relative thickening or scarring called tendonosis. Generally, this is present if pain is chronic or not relieved with ice therapy or ibuprofen.
  

Plantar fasciitis is one of the most commonly diagnosed foot ailments.  Please contact us to see how we can treat your symptoms and help you avoid further pain.