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Common Injuries Of The Foot/Ankle Complex

May 7th, 2013

"The Ankle/Foot Complex"

Most of the time, our foot is the only part of our body that is in contact with the ground. Due to the time spent on the ground and the forces of our body weight and gravity, the foot has to deal with great loads of stress. If the foot/ankle complex isn’t mobile enough to distribute the stress evenly throughout the lower extremity other areas of your body become affected, knees, hips, lower back, etc. So if there is restrictions in your ankle joint it will very likely work its way to these other areas mentioned.

Poor mobility in the ankle can be due to a number of factors. Having tight calf muscles, primarily the gastrocnemius and soleus muscles, will cause the foot to appear more flexed (toes pointed down) as the gastroc/soleus muscles shorten and become tight. Previous ankle sprains can lead to scar tissue buildup in the medial and lateral ankle ligaments affecting the mobility in the talus bone as it articulates with the tibia. Sprains must be addressed properly to avoid scar tissue buildup and loss of ankle mobility because there will be some other compensatory movement occurring away from the ankle that could lead to lack of stability and possible injury. We often see this “ripple” effect if the symptom is addressed and the dysfunction is not dealt with accordingly.

Some of the common issues seen from lack of ankle mobility include squatting problems. Often seen in exercise, people who lack ankle mobility often have difficulty squatting cleanly and will struggle to keep their heels on the ground.

Another issue we see is foot pain, most commonly, plantar fasciitis. Tightening of the calf structures and Achilles tendon could lead to shortening of the plantar fascia creating pain in the sole of the foot. Other causes of plantar fasciitis could include standing on hard surfaces for longer periods of time, wearing improper shoes, poor biomechanics, repetitive impact activities and many more.

If you are experiencing any of the injuries discussed above, chances are the problem has been going on much longer than the actual pain itself. Get assessed by your healthcare provider to locate the cause of the dysfunctional movement and how to start correcting it. Good luck!

Live your best,

Dr. Brian

Tags: foot pain, myofascial pain, plantar fasciitis, prevention, soft tissue
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A Glimpse At Muscle Pain

October 15th, 2012

Muscle bands are usually pain free, but can become tender and painful, possibly by compressing nociceptors (pain receptors). Focal areas of tenderness are often referred to as “trigger points”. When pain is mostly in muscles and is associated with multiple tender trigger points, it is referred to as myofascial pain syndrome. When the muscle bands are fibrotic and painful, the condition is sometimes known as fibrositis or fibromyalgia, or even diffuse myofascial pain syndrome. The exact cause is unknown but it has many clinical features of the radiculopathic group, meaning changes with our sensory, motor and/or autonomic nervous systems. Some of these features include pain and stiffness of long duration, pain is increased by physical and mental stress, compression and spinal disc degeneration as well as soft tissue swelling and joint pain.

Treatment starts with reassurance that this condition is not crippling, does not weaken joints or muscles and is not life threatening. Place emphasis on muscle conditioning, gradually increasing aerobic exercises such as walking or swimming to enhance improve fitness and maintain motion of the joints.

There are a number of factors that must be taken into consideration when treating pain syndromes. Each person must be given a competent and comprehensive examination of the musculoskeletal system to determine the source of the pain prior to treatment.

Soft tissue manipulation (Active Release Technique, Dry Needling, Instrument Assisted Manipulation) is an effective treatment to release shortened muscles that may be producing myofascial pain. Muscle shortening may also be released by electrical stimulation (Therastim, TENS ).

There are many solutions out there to completely resolve your pain, don’t wait any longer. Take control of your health today and quit living in pain!

Live your best,

Dr. Brian

Tags: active release technique, fibromyalgia, muscles, myofascial pain, pain
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Common Injuries Of The Upper Extremity

October 11th, 2012

The shoulder is a very complex and mobile joint but it is also one of the most unstable joints in the body. When compared to a ball in socket joint like the hip, it is the complete opposite. The glenohumeral joint (shoulder) is stabilized by many muscles working in a coordinated manner to provide a great deal of motion. When there is muscle dysfunction such as inhibition or weakness of the rotator cuff muscles, there is usually pain through a specific range of motion as well as a pinching sensation or clicking in the shoulder. There are many possibilities to consider with upper extremity injuries but here are a few common ones seen in my practice:

- Impingement Syndrome: This usually involves the supraspinatus tendon as it travels under the acromion of the scapula to attach to the lateral humerus. It can occur during various shoulder movements but usually with abduction (lateral movement of arm) around 60-120 degrees.

- Labral Tears: These are most common with traumas such as falling on an outstretched arm as well as being associated with repetitive strain injuries of the shoulder complex. Poor shoulder stabilization is a common finding with this injury as well.

- Bicipital Tendonosis: Not to be confused with inflammation of the tendon, this refers to a degenerative change in the biceps tendon. This kind of degeneration generally occurs due to overuse as well as poor biomechanics of the scapular-humeral complex. Performing repetitive exercises such as bicep curls, dips and bench presses while the shoulder complex isn’t optimally positioned can lead to excessive strain of the biceps tendon.

Reducing your chance of experiencing these injuries can be accomplished through shoulder stabilization exercises as well as minimizing repetitive motions of the shoulder. Soft tissue manipulation combined with exercises designed to stabilize the glenohumeral joint have proven to be an effective combination to resolve shoulder injuries as well as reducing the likelihood of further dysfunction.

Live your best,

Dr. Brian

Tags: glenohumeral joint, muscles, rotator cuff, shoulder pain, soft tissue, tendons, upper extremity pain
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