Running technique is very important for injury prevention. Issues involving how you place your foot on the ground and how you hold your body can make a difference in both speed and avoiding running repetitive use injury. There are many different opinions on running technique. Here I will offer you some basic technique ideas for long and middle distance running.

Here are a few tips for the upper body:

• Head held upright over your shoulders and relax your face
• torso leaning forward slightly
• arms moving in the direction you are running and not crossing over your body
• keep arms tucked into your sides
• arms moving using cross crawl mechanism (right moves forward with left and vise versa)
• keep shoulders and hips as still as possible with no twisting or one sided back/forward motion
• hands loosely closed and relaxed with lower arms above hips (elbows near 90 degrees)

Your lower body technique is the most important and complicated part of your running technique:

• whether you have chosen forefoot or heel striking your foot should already be in a backward motion when it strikes the ground
• at a moderate pace your knee should be the heels highest point and as the pace quickens you should be bringing heel higher
• foot plant should be just in front of the center of gravity
• lengthening the stride is done by bringing thigh further forward not by increased knee extension
• as the thigh comes forward relax the hamstring to allow the lower leg to come forward
• keep your motion moving forward and limit the "bouncing" up and down movement

In general keep your body relaxed and try not to consume needless energy.

By improving foot and ankle function/biomechanics you can reduce loss in joint and muscle tension when the foot is on the ground and deceleration is occurring. Feel free to contact me if you have a specific injury such as shin splints, sprained ankle, ankle instability, or knee pain. It's also a good idea to have your hips, knees, ankles, and feet examined even if you are pain free. Prevention is always easier than reactionary care.

I thought I would share this news video from California highlighting Graston Technique.  I use this technique and other chiropractic care to treat sports injuries in my Northwest Portland Chiropractic office.

Don't Let Muscle Pains and Strains Affect Your Holiday Travel.

Holiday travel can be tough on your body. Whether driving a few hours to visit the in-laws or flying cross-country for a week-long holiday excursion, you can hardly make the most of your time if the trip leaves you tired, stressed, stiff and sore.

“Long periods of sitting can take a toll on your body,” says Dr. Scott Donkin, a chiropractor, ergonomics expert and author of the book, Sitting on the Job. “Research shows that sitting in place for prolonged periods of time can decrease blood circulation, stiffen muscles, induce fatigue and, in rare cases, cause blood clots that can lead to life-threatening conditions, like deep vein thrombosis.”

The American Chiropractic Association recommends the following in-flight exercises to help travelers avoid muscle tension and stiffness:

Foot Pumps

Start with both heels on the floor and point your feet upward as high as you can. Return both feet flat on the floor. Then, lift your heels high, keeping balls of feet on the floor. Repeat the three stages in a continuous motion and in 30-second intervals.

Ankle Circles

Lift one foot off the floor. Draw a circle with your toes 10 times in a clockwise rotation, then 10 times counter-clockwise. Relax. Repeat with the other foot.

Knee Lifts

While in a seated position –with your back straight and feet flat on the floor –lift the right foot a few inches off the floor while keeping the knee bent at 90 degrees. Alternate legs. Repeat 20 to 30 times for each leg.

Shoulder Rolls

Gently roll your shoulders forward, up, back and down. Repeat in the reverse direction. Repeat several times.

Neck Rolls

With your shoulders relaxed, drop one ear to your shoulder and gently roll your neck forward and back, holding each position about five seconds. Repeat five times.

In addition, keep your blood flowing by walking up and down the aisle periodically, when permitted by aircraft personnel; keep your legs uncrossed; wear comfortable clothing; and drink plenty of water.

“Because travel can completely change your regular routine, it can be very tough on your body and stressful, too. See your chiropractor to help assure healthy travel,” says Dr. Donkin. “He or she is trained to diagnose and relieve problems of the spine and nervous system.”

This article provided by the American Chiropractic Association.

As a Portland Chiropractor treating sports injuries I do my best to stay on top of the scientific research in this field.  Here is a report on a study that looked at soccer injuries and how Chiropractic care helped to prevent them. 

A new Macquarie University study involving two Australian Rules football clubs has found that chiropractic treatment can significantly reduce the risk of players succumbing to hamstring injuries and lower limb muscle strain.

Two semi-elite Victorian Football League (VFL) clubs participated in the research, which is the first Australian study to examine the role of chiropractic treatment in minimising injury in footballers.

The study was undertaken by sports chiropractor Wayne Hoskins as the basis for his PhD project on hamstring injuries and has just been published in the journal BMC Musculoskeletal Disorders.
 
"Hamstring and lower limb muscle strains are the most common injuries in the AFL," Hoskins said. "The AFL's injury survey shows no change in injury rates in the last 15 years and management of these injuries has remained a source of frustration for players, clubs, medical staff and fans alike."

Hoskins' research showed that hamstring and lower limb muscle strain injuries can be dramatically reduced through the inclusion of a sports chiropractor in the traditional injury management programs adopted by clubs, which generally involve a mix of physiotherapy, massage, and strength and conditioning management.

Hoskins said the results suggest that the inclusion of chiropractic treatment would boost player performance whilst saving clubs money.

"The study lasted an entire season and involved 59 players from two VFL clubs," Hoskins said. "The group which included chiropractic management had a four per cent chance of a hamstring injury and a four per cent chance of a lower limb muscle strain. The group which received the traditional management only had a 17 per cent chance of hamstring injury and a 28 per cent chance of a lower limb muscle strain."

In addition, the chiropractic group missed just four matches during the season through hamstring or lower limb muscle strains. The group not receiving chiropractic treatment missed 14 matches through hamstring injury and 21 matches through lower limb muscle strain.

The group receiving chiropractic treatment also had significant reductions in non-contact knee injuries, low back pain, and improvements in physical components of health, although this was not the goal of treatment.

The study was carried out under the supervision of Associate Professor Henry Pollard from Macquarie University's Department of Chiropractic.

-as printed by Science Alert April 19, 2010

What are shin splints and how did I get them?

As a sports chiropractor in Portland I see a lot of running injuries.  Shin splints is one of the most common running injuries.  Shin Splints is an entirely too vague of a term describing exercise induced lower leg pain.  The term shin splints is used by runners to describe their symptoms or by a doctor as a diagnosis.  Shin splints is essentially the strain of a muscle and its attachment to the tibia.  A more specific term would be tenoperiostitis or traction periostitis.  There are two types of shin splints, posterior and anterior.  Posterior shin splints are on the inside (medial) side of the shin and it's also called postero-medial shin splints or medial tibial stress syndrome.  Posterior shin splints involve the tibialis posterior, flexor digitorum longus, and the flexor hallicus longus muscles.  Anterior shin splints, also called antero-lateral shin splints, involves the tibialis anterior muscle. 

Shin splints is a repetitive/overuse type of injury.  The primary factor in both anterior and posterior shin splints are weak muscles/tendons.  This weakness leads to damage/degeneration of the soft (connective) tissues that connect the tendon to the periostium of the bone; hence the term tenoperiostitis.  When repetitive muscle contraction, of one or more of the above mentioned muscles, is too forceful this painful condition results. 

Repetitive impact is the most common cause of shin splints.  Shin splints is not limited to running, but you can bet there is probably running involved in the sport if shin splints is an issue.  Several factors play a role to increase the likely hood you will have problems with shin splints:  long distances, hills, hard/uneven surfaces, training errors (too far, too fast, too soon), changes in routine, new activity, inappropriate shoes, poor conditioning, inadequate warm-up, over pronation/under controlled pronation, and over training.

 

How can I prevent shin splints?

Prevention questions are among the most important questions I answer as a Portland Chiropractor.  I work with a lot of athletes in a preventative manner.  The most important thing you can do to prevent shin splints is to not make any training errors.  Don't run too much, too fast, too soon.  The most common training errors are when you increase your mileage or speed too quickly.  This also includes avoiding over training. 

There are specific exercises that can be done to help prevent shin splints.  It's simple:  Strengthen the muscles listed above as the culprits in shin splints.  Running on softer surfaces lessens the impact on the leg and in turn decreases your vulnerability to shin splints.  If you run on uneven surfaces, as in trail running, make sure you build mileage slowly so your body has time to adapt to this type of stress.  Always be sure you get an adequate warm-up before your running event, especially if your sport involves sprinting.  Have a coach look at your technique and consider using a technique that can help decrease the impact stresses on your leg/shin.

Treatment of shin splints:

The treatment of shin splints usually involves temporarily limiting or stopping the offensive activity.  The most effective therapy for shin splints involves the use of Graston Technique, ice, rehab exercises,stretching, and kinesio-taping.  Proper evaluation of the entire kinetic chain should be performed by a qualified practitioner.  Manipulation of the low back, SI, knee, ankle, and foot joints can also be helpful.  The athlete can also use a compression sock or have the shin taped for running.  A change in shoes may be helpful.

There are many other factors that should also be addressed with shin splints; these issues include foot positioning at foot strike (foot flair), hip position (externally rotated hip), stride length (too long of a stride), and leg length inequality.  Weak quads, hamstrings, hip abductors, or hip flexors can also be a factor with an athlete suffering from shin splints.

How long will my shin splints last?

When you start feeling the pain of shin splints the condition has more than likely been going on for a significant amount of time.  If you seek treatment immediately after you start feeling the pain the condition should significantly improve in 1-2 weeks.  If the condition is chronic it could take months to resolve.  Treatment should continue after the resolution of pain to reduce scar tissue/adhesions.  If you are being treated for shin splints and are not seeing improvement consider one of the other possible causes for shin pain listed below.  Be sure that all of the factors listed above have been addressed.

All shin pain is not shin splints!

Other shin pain that is NOT shin splints:

-Tibial Stress fracture

-Compartment syndrome

-Intermittent claudication

-deep vein thrombosis

-thrombophlebitis

If you have any questions about shin splints or other running/sports injuries feel free to comment on this blog.  If you live in the Portland area and need treatment for a sports injury or have any questions please visit my website:  www.drbradfarra.com

As a Sports Chiropractor in Portland there is a great demand to have an effective soft tissue therapy.  A sports physician must be able to treat muscle, tendon, ligament, scar tissue, fascia, and other soft tissues.  Many of you know I have been using Graston Technique to effectively treat different soft tissue injuries.  Graston is extremely effective with running, cycling, swimming, and other sports injuries.  Here is some specific information about Graston Technique.

Graston Technique® is an interdisciplinary treatment used by more than 7,500 clinicians worldwide—including athletic trainers, chiropractors, hand therapists, occupational and physical therapists.

GT is utilized at some 825 out-patient facilities and industrial on-sites, by more than 125 professional and amateur sports organizations, and is part of the curriculum at 32 respected colleges and universities.

The Graston Technique®, originally developed by athletes, is changing the way clinicians — including athletic trainers, chiropractors, physical therapists, occupational therapists — and patients view treatment of acute and chronic soft tissue injuries.

Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The Technique utilizes specially designed stainless steel instruments  to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.

The curvilinear edge of the patented Graston Technique® Instruments combines with their concave/convex shapes to mold the instruments to various contours of the body. This design allows for ease of treatment, minimal stress to the clinician's hands, and maximum tissue penetration.

The Graston Technique® Instruments, much like a tuning fork, resonate in the clinician's hands allowing the clinician to isolate adhesions and restrictions, and treat them very precisely. Since the metal surface of the instruments does not compress as do the fat pads of the finger, deeper restrictions can be accessed and treated. When explaining the properties of the instruments, we often use the analogy of a stethoscope. Just as a stethoscope amplifies what the human ear can hear, so do the instruments increase significantly what the human hands can feel.

Graston Technique® offers many advantages and benefits.

For the clinician:   Provides improved diagnostic treatment   Detects major and minor fibrotic changes   Reduces manual stress; provides hand and joint conservation   Increases patient satisfaction by achieving notably better outcomes For the patient:   Decreases overall time of treatment   Fosters faster rehabilitation/recovery   Reduces need for anti-inflammatory medication   Resolves chronic conditions thought to be permanent For employers and the healthcare industry:   Allows patients to remain on the job   Reduces the need for splints, braces and job-site modifications   Contributes to reduction of labor and healthcare costs, direct and indirect

Clinical Applications of the Patented GT Instruments

The Graston Technique® (GT) Instruments, while enhancing the clinician's ability to detect fascial adhesions and restrictions, have been clinically proven to achieve quicker and better outcomes in treating both acute and chronic conditions, including:

Cervical sprain/strain (neck pain)	Lumbar sprain/strain (back pain)
Carpal Tunnel Syndrome (wrist pain)	Plantar Fasciitis (foot pain)
Lateral Epicondylitis (tennis elbow)	Medial Epicondylitis (golfer's elbow)
Rotator Cuff Tendinitis (shoulder pain)	Patellofemoral Disorders (knee pain)
Achilles Tendinitis (ankle pain)	Fibromyalgia
Scar Tissue	Trigger Finger
Shin Splints

Press Release:

Dr. Brad Farra has obtained the postgraduate designation of Certified Chiropractic Sports Physician (CCSP) by the American Chiropractic Board of Sports Physicians (ACBSP). The CCSP certification requires the doctor to attend a minimum of 100 hours of a 120 hour postgraduate program. This instruction is specific to physical fitness and the evaluation and treatment of injuries encountered in sports. Following completion of these hours, the doctor must then take and successfully pass a comprehensive written examination.

This training will aid the doctor in the prevention and treatment of athletic injuries by enhancing his diagnostic skills and patient care. The CCSP accreditation exists to provide a uniform standard of education that assures teams and athletes that the doctor has met a minimum level of competency in chiropractic sports medicine. Dr. Farra joins 4000 others internationally who hold this designation.

If you are interested in having your sports event covered please contact Dr. Farra.

Last spring I wrote a blog on Tennis elbow.  I thought it was time to re-post and update some information.  As a Sports Chiropractor in Portland Oregon I treat a lot of sports and extremity injuries and tennis elbow is very common.  Tennis elbow has also been called carpenters elbow and is referred to by health care professionals as lateral epicondylitis. All of the activities associated with tennis elbow include some type of hand use. Tennis players are only responsible for a small percentage of these injuries. In addition to the activities listed above there are many other possible causes including: computer terminal use, plumbing, carpentry, bowling, and too many others to list.  Tennis elbow is a repetitive use injury, not caused by a single traumatic event.

Tennis elbow usually comes on slowly with pain in the outside (lateral side) of the elbow. Sometimes the condition will go away on its own by removing the offensive activity, but it usually requires treatment for full recovery and avoidance of flare ups. Current research provides evidence that this is not an inflammatory condition, but more of a chronic degenerative condition; this explains why cortisone shots and anti-inflammatory drugs are ineffective for this condition. It should also be mentioned that cortisone shots have been shown to weaken tendons and connective tissues and should not be injected directly into a tendon.  Treatment should always begin with conservative measures. Tennis elbow is at times slow to respond to treatment, but rarely needs more invasive treatments like surgery. Conservative therapy usually includes modification or elimination of the offensive activity; for example a tennis player may need to take a break from tennis, limit the backhand swing, or at a very minimum use the two handed backhand and improve technique. In office treatment consists of soft tissue therapy, elbow joint manipulation, and ultrasound. An extremely effective type of soft tissue manipulation for tennis elbow is Graston Technique (www.grastontechnique.com). It is important to begin rehabilitation exercises including stretching and strengthening as soon as you have your elbow condition diagnosed. In less than 5% of cases surgery is needed where conservative therapy has failed. Surgery for tennis elbow is 80-90% effective.

If you did acquire your tennis elbow with your powerful backhand a few tips might be helpful if you are unwilling to take a break from tennis and you want to continue playing while receiving treatment: change your racket (avoid high string tension), get in a long warm up, use a larger hand grip, avoid Kevlar string, use string dampers, counter weight handle of racket (retrofit handle), use a brace (counter force strap), play on slow surfaces with new and dry balls.

If you are like most people and have acquired a nasty case of tennis elbow from too much computer use.  Have someone work with you on your work station ergonomics and posture.

If you are seeking treatment for this condition go to www.drbradfarra.com for information about scheduling.

I hope you find this information helpful and as always if you have any questions please don't hesitate to contact me. drfarra@drbradfarra.com

Wintertime running can be safe and enjoyable provided you make a few adjustments.

You may wonder what a Southerner could possibly teach you about cold-weather running. Well, I may live in Atlanta, but I travel enough to have logged plenty of miles in the ice and snow. I admit that when I first began visiting places like Minneapolis, Winnipeg and Boston in the dead of winter, I was tempted to limit myself to indoor exercise. But after seeing a steady stream of runners head out to face the elements, I eventually followed them.

What a pleasant surprise to discover that, with a few adjustments, I could enjoy a run in 20-degree temperatures as much as a 70-degree run! Through trial and error I learned how to adapt traditional running advice to the vagaries of cold weather. Here's what I found.

Form and stride: A long stride is perilous on ice and snow, where footing can be dicey. A shorter stride is more stable because it keeps your feet more directly underneath your body. Another way to add stability is to decrease your "bounce." By keeping your feet close to the ground and taking some of the spring out of your step, you'll gain more control.

Warming up and cooling down: Because cold reduces the flexibility of muscles and tendons, a thorough warm-up is crucial. Here's one that works particularly well on cold days: Start by walking, then walk and jog for a few minutes, then jog slowly for a few more minutes before easing into your normal running pace.

If you'd rather hit the ground running, warm up indoors. Jog in place or spin easily on a stationary bike for a few minutes until you break a sweat. Then suit up and head out the door.

The very idea of "cooling down" may seem ridiculous when you're sprouting icicles, but a gradual transition from outdoors to indoors is smart. (Going straight from arctic temperatures into a hot shower can tax the heart.) Cool down by reversing the warm-up process: Ease your running pace into a slow jog, then walk and jog for a few minutes, and end with a few minutes of walking.

Hydration and nutrition: Believe it or not, winter running can dehydrate you. So don't neglect to drink. No matter what the weather, drink plenty of water throughout the day. If you're running long enough to require energy bars or gels, stash them close to your body to keep them from freezing.

Intensity: Even on a clear running surface, going all-out in very cold weather has some risks. I've seen many well-trained runners suffer pulled muscles when weather conditions changed during a workout. It's possible-after a good warm-up-to do some gradual accelerations during an outdoor run without much injury risk, but intense speed sessions are best done on a treadmill or indoor track during the winter.

Four Cold-Weather Myths

Don't know what to believe when it comes to winter running? Here are the cold facts:

Myth: You'll freeze your lungs.
Fact: There's no evidence that exercising in cold weather, even in extreme cold, will hurt your lungs. If the cold air hurts your throat, breathe through a bandanna or a polypropylene face mask.

Myth: You'll burn more calories when you run in the cold.
Fact: When you run continuously, you burn roughly 100 to 120 calories per mile. The air temperature doesn't significantly change this.

Myth: You don't have to drink as much when it's cold.
Fact: Most people sweat about as much during winter runs as they do during summer runs, but many runners don't recognize dehydration as easily during the winter. When in doubt, drink.

Myth: We're meant to hibernate during cold weather, not run.
Fact: Just take a trip to the Twin Cities in February and see how many people are running outside, enjoying the subzero temperatures. With the right clothing and a positive attitude, you can adapt to just about any type of weather.

Reprint: Runner's World, January 2000, p. 30

When snow, ice and frigid winds blast into town, watch out. If your body is not in condition, the common winter chore of snow shoveling can present the potential for spasms, strains, sprains and other health problems, warns the American Chiropractic Association (ACA).

Bending and twisting when tossing a shovel of heavy snow can aggravate lower back discs, according to the ACA. In addition, the overall physical exertion required for snow shoveling, without proper conditioning, often results in painful injuries.

The ACA advises you to be prepared and follow these tips for exercise of the snow shoveling variety:

• Be prepared. Maintain your exercise program year-round.
• Listen to weather forecasts so you can rise early and have time to shovel before work; rushing the job can lead to injury.
• Wear layers of clothing to keep your muscles warm and flexible.
• Do some stretching before you grab the shovel.
• For big jobs, use a motorized snow blower. If you shovel by hand, use a lightweight, ergonomically designed shovel to reduce back strain.
• When you do shovel, push the snow straight ahead. Don't try to throw it; walk it to the snow bank. Avoid sudden twisting and turning motions.
• Bend your knees to lift when shoveling. Let the muscles of your legs and arms do the work, not your back.
• Take frequent rest breaks to take the strain off your muscles. A fatigued body asks for injury.
• Stop if you feel chest pain, or get excessively tired or have shortness of breath. You may need immediate professional care.
• If you feel sore after shoveling, apply an ice bag to the affected area for 20 minutes, then take it off for a couple of hours. Repeat a couple of times each day over the next day or two.