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Therapeutic LASER, Class IV

Brad Farra - Monday, June 11, 2012

As a part of my continued commitment to providing cutting edge effective therapies, I am introducing class IV laser therapy into my practice.  Laser therapy will be an adjunct therapy to the services I already provide.  Laser therapy will fit in nicely with the other surgery free and medication free evidence based therapies I provide.  This blog will serve as a thorough description of how laser therapy works.  As always, if you have questions, please don't hesitate to ask.  You can post a question at the bottom of this blog or email me at:  drfarra@drbradfarra.com

There are thousands of published research studies supporting the efficacy of laser therapy for many different conditions.  Laser therapy has been used in Europe for over 40 years and extensively in the US for over 10 years (our FDA is a little slow!).  Laser therapy or 'photobiomodulation' is the use of specific wavelengths of light (red and infared) to create therapeutic effects.  Class IV therapeutic laser refers to a class of powerful lasers that provide penetration into deeper injured tissues.  Laser treatment times average between 3 and 9 minutes depending on the size of the area being treated.  This leaves plenty time for other needed treatments during the visit such as rehab. soft tissue therapies, and joint manipulation.  There are very few clinics in Portland that offer such an advanced and powerful laser. 

Some of the clinical effects include accelerated healing time, pain reduction, increased circulation, decreased swelling/inflammation, and decreased scar tissue formation.  Treatment with laser therapy is painless and can reduce muscle spasm and stiffness, which can lead to immediate pain relief.  The infrared light of laser therapy interacts with the tissues at the cellular level to increase cellular metabolic activity.  This increase is cell activity improves transport of nutrients across the cell membrane and increases production of ATP (an energy carrier).  This increase in ATP leads to a cascade of beneficial effects that improve cell function and health. 

Because of the wide ranging effects of laser therapy bio-stimulation it has the ability to help with a broad range of conditions.  Laser therapy can be used all over the body including conditions of the knee, foot, ankle, hip, back, neck, shoulder, wrist, hand, elbow, arm, leg, thigh, and head (not eyes!).  Examples of specific conditions that laser therapy is effective treating include:  ligament sprain, tendon or muscle strain, tennis/golf elbow (epicondylitis), carpal tunnel syndrome, myofascial trigger points, back pain, tendinopathies, repetitive stress injury, chondromalacia patellae, IT band syndrome, arthritis, plantar fascitis, shoulder injuries, traumatic/acute injuries, swelling/edema/inflammation, sports injuries, auto accident injuries, headaches, cervical or lumbar disc herniation, TMJ pain, ankle sprain, and achilles tendinopathy.

 That's the basics of laser therapy.  I will now go into some greater detail of the physics and physiology of laser therapy.  If you don't want to read the nerdy detail, just know that combined with the accurate diagnosis and other therapies I provide, laser therapy will help you get better faster with fewer treatments and less overall injury duration.  Of course, if you have any questions or are wondering if laser can help  you, please don't hesitate to email me.

LASER Therapy Physiology

Photobiomodulation is the accepted term for laser therapy.  Laser therapy is a form of light therapy.  Light (photons) is applied to the tissue.  The photons are absorbed by chromophores in the mitochondria and cell membranes.  These chromophores are special light absorbing molecules involved with the electron transport chain in the mitochondria and they allow for a photo-chemical reaction in which the cell converts this photon energy to ATP.  The additional ATP accelerates DNA & RNA synthesis, mitosis, and in some situations cell proliferation.  The end result is a myriad of cellular affects including accelerated tissue repair, resolution of inflammation, and pain reduction.  Compromised cells and tissues respond to laser therapy more readily than healthy cells and tissues.  As you can see laser therapy does not just treat symptoms, it actually promotes and enhances healing.

An important effect of laser therapy is vasodilation, which brings more nutrients and oxygen to injured tissue.  This increase in circulation also improves lymphatic drainage, which is in part responsible for the analgesic effect and improved tissue regeneration.

Inflammation is one of the first responses from the body after an injury.  Laser therapy can mediate the inflammatory response by stabilizing the cell membrane and decreasing levels of C reactive protein and neopterin.  Laser therapy also accelerates leukocyte activity, superoxide dismutatse, lymphocytic response, reduction of interleukin 1, increased angiogenesis, and of course vasodilation.  If inflammation is not kept in check healing will be slow.

Acceleration of leukocytic activity enhances removal of non-viable cellular and tissue components.  An increase in macrophage activity is also seen with laser therapy.  While scar tissue can sometimes be a necessary part of healing, it also can be a source of pain and dysfunction.  Laser therapy can limit the production of scar tissue formation after an injury.  Combined with the rehab and massage techniques I provide, this scar tissue will be remodeled and functional in no time!

Laser therapy can also enhance local immune system cellular components.  Increase of lymphocytic proliferation including helper T cells and suppressor T cells.  A modification of beta cells also occurs.

The pain reduction capability of laser therapy is done by way of local and systemic reactions.  This process includes ion channel normalization, an increase in beta endorphins, decreased bradykinin levels, increased levels of acetylcholine, axonal sprouting and nerve cell regeneration, a decrease in the firing of pain fibers and normalization of resting potentials.  Less pain while a condition heals means you don't have to take medications that are loaded with side effects.

Laser Therapy Physics

Therapeutic laser is all about physics!  Without the right combination of physics the above mentioned physiological effects would not be possible.  Laser is an acronym; Light Amplification by Stimulated Emission of Radiation, LASER.  The important characteristics of a therapeutic laser include:  Wavelength, power, frequency,  and wave emission characteristics.

Laser light is able to create coherent light at a very specific wavelength.  That is to say, laser light is monochromatic.  Coherency of laser light allows for a focus of light in a very specific area and is not easily dispersed.  This unique characteristic of laser light allows for a greater power density and a more favorable acceleration of the healing process when compared to non-coherent light.  Scientific research shows us that a range of wavelengths from 600 to 1000nm is able to promote healing of skin, muscle, nerve, tendon, ligament, cartilage, bone, and other tissues.  When tissues are injured they respond positively to specific doses of this light energy.  The closer the wavelength is to that 1000nm level, the deeper it will penetrate.  The problem is, the laser light is also absorbed by matter other than the injured tissue.  Many studies have been done to determine wavelength absorption characteristics.  An ideal wavelength for human tissue is 800nm, because it is minimally absorbed by water.  A deeper penetrating wavelength is 970nm.  Although 970nm is absorbed more by water, it's absorbed less by melanin.  This is an important wavelength to have for a dark skinned individual.  Combining the 800 and 970nm wavelengths is ideal.  The combination of these two wavelengths, and the ability to use just one or the other, allows for maximum absorption by injured tissue regardless of your skin color.


Another characteristic that determines the depth of penetration is power.  A laser can't just rely on wavelength to deliver appropriate dosage to deep tissues.  Without enough power the laser light will be absorbed before reaching deep target tissues.  Cases in the literature where laser therapy was found to be ineffective for treatment of a particular condition, the primary reason was not enough power and the dosage of laser light energy to the injured tissue was inadequate.  Not only does power allow for deeper penetration of the laser light, it also allows for shorter treatment times with a greater clinical effect.  Power is measured in watts, much like a light bulb.  A higher power laser is a brighter light and able to 'shine' to a greater depth.  Class IV lasers are the most powerful and thus the most effective therapeutic lasers available.

The frequency of laser light is another important characteristic.  Continuous wave has no interruption of output.  Pulsed light can be at any frequency and is measured in cycles per second or hertz.  Different problems respond differently to various frequencies.  For example, an acute condition might respond more favorably to a high frequency and chronic conditions to a low frequency.  The ability to transmit laser light of different frequencies is important to optimize treatment for many different types of conditions.

Congratulations on making to the end of this blog.  Please feel free to contact me if you have any questions.



Portland Chiropractor - Graston Technique news video

Brad Farra - Saturday, October 30, 2010

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.

Chiropractic Care Cuts sports Injuries

Brad Farra - Tuesday, June 22, 2010

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.

Chiropractic Care Cuts Sports Injuries 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

Portland Chiropractor - Shin Splints

Brad Farra - Monday, June 07, 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


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

Portland Chiropractor - Graston Technique

Brad Farra - Sunday, May 30, 2010

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)
Scar Tissue
Trigger Finger
Shin Splints

Certified Chiropractic Sports Physician

Brad Farra - Tuesday, January 12, 2010

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.

Portland Chiropractor - Tennis Elbow

Brad Farra - Tuesday, January 12, 2010

Tennis Elbow

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

Winter Running

Brad Farra - Tuesday, January 05, 2010

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

Warm Up & Stretching

Brad Farra - Monday, November 09, 2009

If you have ever been a patient of mine you know that I think a warm up before any athletic performance is important. Equally important is the post exercise stretching.

A good warm up should increase muscle and core temperature, increase blood flow, and prepare your soft tissues for work. No one really argues the point that a warm up is important. Warm up allows for a faster muscle contraction and relaxation, improves strength and power, increases blood flow to working muscles, enhances metabolic reactions, and even improves oxygen delivery. Improved injury prevention is probably the most important benefit of a good warm up.

While the importance of a good warm up is not disputed, it seems that we will be arguing about when to stretch and when not to until robots have taken over the planet and there are no more muscles to stretch. Until the humans are dead I'll try to sort through the research to give you some guidelines.

With sports that require an increased range of motion pre-exercise stretching should be performed after warming up. An examples of a sport requiring a maximum range of motion is gymnastics. In other sports static stretching can reduce muscle performance, but the evidence is somewhat conflicting. The most important time to stretch is after your activity. Post exercise stretching facilitates improvements in flexibility and helps prevent injury. I often tell my patients that are runners that if they don't have time to stretch after their run, then they don't have time to run. Stretch after your exercise, you'll thank me and you won't be in my office with an injury that needs treatment.

Running is NOT Bad for Your Knees!

Brad Farra - Tuesday, October 13, 2009

It's never my running patients that wonder if running is bad for their knees, it's the non-running folks that tell me running is bad for their knees. Running is not bad for your knees. It's been proven time and again with solid research that running can actually be good for your knees. This doesn't mean it's good for everyone or that there aren't reasons you shouldn't run. If you have specific questions about whether you should run or not, then speak with a Chiropractic sports physician or another physician that treats sports and extremity injuries. Below is a link to an article from the New York Times that references some current research highlighting the positive influence of running on your body. I think the most important thing for runners to keep in mind is that you must prepare your body for running and if you don't run regularly you must ease into the sport. Specific stretching and strengthening should be done before and after running to reduce the chance of injury.