Shin Splints No More!

Working with runners of all kinds, I see a lot of “shin splints”.  When I was a collegiate athlete, I had my share of shin problems, to say the least!  I had multiple stress fractures, tight calves, and strained muscles.  I had to bike, swim, and strengthen like crazy just to complete long runs!

Now that I have an athletic therapy background and some experience under my belt, I understand better how this can be prevented and treated before stress fractures and muscle tears occur.

What are “shin splints”:

Shin splits is a bit of a garbage term.  It can mean: muscle tears, tendonitis, fractures, compartment syndrome, or tightness.  Most people suffer from weak tibialis posterior or tibialis anterior muscles.  Calves are usually too tight and a muscle imbalance results.

The Simple Prevention: 

Running shoes are so important for high level athletes as well as recreational runners.  Having a fresh pair of shoes that are under 8 months old is likely the easiest prevention.  Shoes that work to keep you straight is an important investment.  If you tend to over-pronate, are a heavy runner, or do a lot of mileage, you need more motion control in your shoes.  If you have a high, rigid arch and are heavy on your heels, you need a more cushioned shoe.

Training Errors:

Increasing your mileage too quickly (taking the summer easy then ramping up for an indoor track season) when you’re not strong is the best way to get shin pain.  Mileage must be increased moderately and your base fitness should be maintained all year long.  This includes volume as well as intensity of the runs.  Another training error is not allowing enough recovery time.  As you build your mileage, allow for a recovery or drop back week.  Giving your nervous system some regeneration and soft tissue a chance to repair makes your harder weeks much more effective.

Strength:

Having the strength in your lower legs will help your legs not get so fatigued resulting in microtears – leading to injury.  Ankles need to be stable and not over reactive to ground forces.  Knees need to be strong (which comes from glute strength).  Runners tend to neglect their lower legs assuming that they get enough work from running.  You need resistance with the training so the forces working on the body with running are much less. See the exercises below on how to accomplish some specific strength.

Stretching:

After each run, ensuring that you are stretching your shins, calves, and the bottom of your foot is crucial.  A good 10 minute stretch routine post run is the bare minimum for proper recovery and injury prevention.

Solution:

Here is a short routine that can be done daily to maintain or build strength in your lower legs.

1. Toe tapping 3 x 20 taps

2. Walking on your heels while brushing your teeth

3. Inversion with a band 3×12

4. Eversion with a band 3×12

5. Dorsiflexion with a band 3×12

This will help to build and prevent shin pain especially overuse injuries.  If you have been injured, seek treatment sooner rather than later.  Muscle tears are much harder to treat and will put you out of commission for 6-8 weeks.

Jen Mark BSc., CAT(C), CSCS
Athletic Therapist
www.dynamicliving.me
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No more crunches!

Ok, we all want rock solid abs, I get it.  And having a strong core is the biggest buzz in the fitness industry – and for good reason.  So why can’t we do crunches anymore?

Remember back in the day those who were working out, were performing sit ups?  This was how fitness lovers and athletes got those abs of steel.  Then science caught up and saw evidence that doing all those sit ups were causing back injuries.  If we look close enough at the mechanics, your hip flexors (iliopsoas group) are doing most of the work and they originate in your lumber spine.  All this excessive pulling on the spine was leading to back injury.  So we all stopped doing sit ups and moved to crunches.

Now science has caught up to crunches.  There is evidence to suggest that doing a crunch can load your spine up to 150 times.  Constantly flexing the spine and overusing one muscle group will never create balance in the body.  Ask me how I feel about machines such as leg curl!!  Our spines are pretty fragile and precious, so we must find another way.  Something that science can’t debunk!

Let’s talk for a second about what your core is and what it’s role is.  Your real “core” includes your deep pelvic muscles (creating a pelvic floor), your transverse abdominis (under your 6 pack muscles), and your multifidus muscles (attaching to each vertebrae in the spine).  The job of these muscles is to stabilize your pelvis, to limit excessive movement.  If your core is strong, you will be able to lift heavier weights, run faster, jump higher etc.  All because your “base” is stable.

There are a few exercises that are needed to get  your core strong.  Keigles are one method for women and men can think about “stopping the flow” (holding in your pee).  If you want to learn about setting your core, visit my website and check out the video.  It’s easier to show that to type!

So once you can activate your core, here are some fun exercises that are commonly done incorrectly.  I typically see poor posture which is a result of a weak or unactivated core.  Most people tend to rush these exercises – remember when doing this type of training, the pelvis should be stable.

The plank on the stabilty ball is a staple exercises – focus on good posture, neutral spine, and hands under your shoulders.  When tucking your knees in, your back does not change and the movement is smooth and controlled.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

When using the ab roller, the same principles apply.  Start in a modified plank position and roll forward maintaining your posture and stable pelvis.  Your body should not change position. just your arms stretch out and back in.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

One note of caution: Core work should not result in back pain.  It is acceptable to feel that your back is doing some work, but not sharp pain.  If you finish the exercise and you feel discomfort in your back, your pelvis was not stable enough and you need to decrease the difficulty of the exercise.

For questions or comments, please contact me.

Jen Mark BSc., CAT(C), CSCS
Athletic Therapist
www.dynamicliving.me

I held a brain!

Last night I found out I had the opportunity to go to a cadaver lab. I jumped at the chance. This morning I was so pumped to get through the morning so I could get into the lab and get a chance to really see the muscles, ligaments, and nerves that have been bugging my clients lately.

I got to the Canadian Memorial Chiropractic College early and got to look around their student shop. I saw lots of things that I will buy, soon. I met the group in the lobby and we went down to the anatomy labs. The smell of formaldehyde was strong, and some of the other students passed around Tiger Balm ointment to put under their noses to take away the smell. I work with hockey players so my smell senses are dead anyways, I didn’t take the ointment. Once inside the lab we put our lab coats on and began to unwrap the first body.

All the bodies we saw looked like dried out turkey. Good thing I’m vegetarian. I got to touch and see and move anything I wanted. I liked seeing the muscles and nerves in the legs the most. We saw a pelvis and scoliotic spine, which was great to see the rotation of the vertebrae at each over-curvature. We saw a spinal cord and got to touch and hold all the nerve roots that were still intact.

And then I got to hold a human brain! It took 2 hands. The over layer (that attaches to the skull – the duramater) was still intact but peeled away. The piamater (the layer right on the brain) was still present and shiny. It weighed about 5-6 pounds and was pretty firm.

We saw black, shriveled, smoker’s lungs, and I got to hold a cancerous liver. All the livers were the
size of a football! The skin that was peeled back is so thick. No wonder I have to dig deep in order to influence the muscles. There was fascia still attached to the bones that still housed blood vessels and nerves. Speaking of nerves…wow! They’re huge! I knew the sciatic nerve was fat (the width of your thumb) but the other nerves are nothing to sniff at. I got to poke and pull at the brachial plexus (the bundle of nerves just above your collar bone). You can see all the branches and roots very clearly.

It is such a great experience to impulsively get plunged into a world that you’ve never been to before. I never say no to any experience and this time it paid off. We only had an hour inside the lab, but I could have spent all day. What a fantastic learning experience! Thanks Joe!

Jen Mark BSc., CAT(C), CSCS
Dynamic Living

From “weakness” to “respect” for the Shoulder Joint

Shoulder injuries like rotator cuff injuries, and conditions like frozen shoulder are hugely painful for the sufferer and frustrating for the teacher or trainer. It’s hard to watch a client stall in their progress due to a shoulder injury. Yoga is a helpful practice in preventing and recovering from common shoulder injuries.  Although every person and every injury are different, practice with consciousness, patience and consistency, yoga is a game-changer. Here are two simple ways yoga helps when it comes to the pre-hab and re-hab of the shoulder joint:

 

Stretch + Strength = Stability: Often people injure their joints because the muscles surrounding them are either too weak (and they can’t support the joint) or unbalanced (and they torque the joint out of alignment).  Yoga promotes balance in flexibility and strength exercises, particularly for the upper body.  It also promotes balanced muscle development, not favoring the bi- over the triceps for example. To prevent injury poses like downward dog, eagle, crescent moon and arm balances (only if the student is already strong enough and ready for the pose) will help to strengthen and lengthen the muscles around the shoulder.  To rehab the shoulder, forward folds, table top, and shoulder rotations will help to loosen things up and start to rebuild shoulder strength. Of course, every shoulder is different, and students should listen to and respect their bodies.  Note: Yoga is amazing for rehab, but yoga is not athletic therapy. If your client is badly injured, they need to see Jen or Katy before coming to a yoga class and they should always advise the teacher of any injuries they have before starting their practice.

Knowing Your Limits:  Ego. Everyone has it, and every personal trainer or yoga teacher has seen it in action: a student who knows they don’t yet have the strength to do so jumps into a pose or exercise before they are ready and they injure themselves in the process.  Letting go of the ego is one of the most important things yoga can do for your clients.  Yoga teaches people to recognize and respect their limits. It helps to reframe perceptions of “weakness” and reprogram them as “respect”.  We need to listen to our bodies when we exercise, and yoga teaches us to listen when they whisper rather than waiting until they scream.  This will result in fewer injuries from overexertion. It will also help to create a smooth path to recovery as students discover and respect their new limitations rather than expecting pre-injury performance. 

Working with a Qualified Instructor: The same principle applies to those working with a personal trainer or coach, as with yoga.  Having an instructor that can follow your movements (small groups are best), and make necessary corrections will greatly help guide your recovery.  Your instructor should be willing to work with your limitations and bring about a fun, safe, and goal oriented yoga session.  Building poses and progressions is more important than actually getting to the advanced pose.  

Thanks to my guest blogger, Jenny Foster, who teaches yoga at Dynamic Living.

Shoulder Stability Workshop Feb 21 at 2pm.  Register today.

Jen Mark BSc., CAT(C), CSCS
www.dynamicliving.me 

Why don’t athletes stretch??!

I can remember years ago, a friend of mine, who was a pro cyclist, telling me she never stretched. I was a personal trainer at the time and always advocated that she start to stretch. She told me that she would spend 25 hours a week on her bike and at the end of the day felt that she had done enough and was too tired to stretch. She started to stretch when she sustained an injury and the doctor told her she really needed to take stretching more seriously!

Fast forward a few years and I am now working with a junior hockey team and division 1 rugby team. I know more about stretching now than I did when I was just training and can you believe hardly any of my athletes stretch! Hockey in general is bad for stretching. I guess it isn’t cool and the same excuse comes out: not enough time. After a rugby game, my girls are tired and ready for a beer. After a hockey game, the boys are ready for bed (and likely a beer that I don’t hear about). I am still personal training and very few of my clients, at the end of our sessions, will stop and stretch. Most are rushing out to get on with their day, my calls for stretching lost in the breeze.

I have been a collegiate athlete in the past and always found stretching to be part of the routine. After a track workout, you stretch. After a long run, you stretch. I still do the same today. I have a rug in my small apartment placed there specifically for stretching after my runs. The odd occasion I too am running on with my day and leave the stretching behind. But 9 out of 10 times I get down on the ground and stretch.

We don’t take enough time in our days to move our bodies and get our joints through their full range of motion. Do you ever put your arms up over your head or reach behind you? Does your heel ever reach your butt? Can you get into a lunge position? And lastly, can you extend your back and lean backwards?? Many people just can’t get into these positions. Children can do it, but as adults we train ourselves out of these positions.

Stretching when the muscles are warm is so vital for good health. Holding the stretches allows you to get a full relaxation of the muscle and get to know your body better. Being on the floor while stretching allows your joints and tendons to relax and allow the muscles to really extend. We can solve and prevent so many problems by simply stretching.

I was at a Rugby Ontario tournament a few weeks ago and had an athlete approach me with knee pain. I showed him how to stretch while we waited to use the massage table. Guess what! The pain went away right away when he started to stretch. And this has been my experience working with athletes and avid exercisers – some pain can be resolved by simply stretching!

Tight people get injured.

Get down on the floor after your workouts or games and stretch. Save time for it. Your body will thank you! And as you get into your later years in life, you’ll appreciate a bit of flexibility when you drop something on the floor or need to put pants on!

We are doing stretching seminars all the time at Dynamic Living. In Toronto and in Gormley. Whatever your sport, you need to stretch.

Jen Mark BSc., CAT(C), CSCS
Dynamic Living

Don Sanderson Symposium on Sport Concussions – Second Annual

Yesterday I attended my first Don Sanderson Symposium on Sport Concussions, at York University in Toronto. Don Sanderson was a York University student playing for the Whitby Dunlops hockey club. He was playing in a regular league game in December when he got in a fight, and his helmet came off. When his head hit the ice at the end of the fight, he went unconscious for 30 seconds, he was rushed to the emergency department in a coma. He stayed in the coma for 21 days until he succumbed to his injury in January. His mother has dedicated her time to the Donald Sanderson Memorial Trust Fund, that raises money for concussion education. The event at York was in part funded by this organization.

Dr. Lauren Sergio (York U Neuroscientist) emphasized that concussions don’t only come from hits to the head. Hard shoulder to shoulder hits, quick decelerations, and anything causing whip lash can lead to a concussive force within the head. The concussion comes from the brain hitting the skull from the inside, not an object from the outside. Dr. Sergio also explained the serious nature of what is called Second Impact Syndrome. It is this syndrome that makes concussion risk management so important. Basically, the brain is always being regulated to have the same amount of blood flow no matter the conditions. So whether you’re hungry, tired, cold, hot, or exercising intensely there is always the same amount of blood flow to the brain. When the brain suffers a concussion this system is compromised and causes an increase of blood flow to the brain. Taking a second concussive force to the brain while there are still symptoms causes an increase of pressure to the brain. This can lead to serious brain trauma or likely death.

Dr. Sergio also talked about some of the questions that are coming out of the current research. Why do some people seem more susceptible to concussions and some get more severe symptoms than others? There could be a biomechanical threshold (the body can only handle so much), the amount of torsion the neck undergoes could be a factor, genetics, the number of hits leading up to the big hit, as well as age and gender could all play a roll. Lastly, Sergio talks about new research that she is involved with that might help trainers on the sidelines. Concussion screening tests, right now, test cognitive function and motor ability separately. This new research looks to testing cognitive and motor skills in combination. Apparently those suffering from dementia will focus on cognitive skills when asked to do both in combination (stop walking in order to talk), while athletes will focus on motor skills.

Next Matt Dunigan, former quarterback (and hall of famer) in the CFL spoke about his experiences with 12 concussions. Fifteen years after retirement, he is still suffering from many symptoms, most notably his personality change. It is a struggle for him to let loose and have fun, as well as control his emotions. He spoke about being a parent to a football player, who has suffered 2 concussions. Dunigan pulled him out of football in order to save his son’s athletic career (Dolan now plays NCAA baseball). Dunigan was an athlete that would go back into play even though the “field was sideways”, or had difficulty seeing the field. No one stopped him, and no one took him out the game. Dunigan’s career ended with a concussion, a routine hit, with symptoms that never went away.

The last expert to speak was Dr. Paul Echlin. For those of you who attended the Concussion Symposium in February at BodySmith, Dr. James Carson who spoke has worked along side Dr. Echlin in prominent concussion research. Dr. Echlin reminded us that the brain is a unique organ that has translation (forwards and backwards) and rotational abilities. Here is a list of astonishing stats that has come from Echlin’s research:

• 300,000 to 2.5 million sport related concussions were reported in the USA last year
• the Canadian sport with the most reported concussions is hockey
• Echlin’s research team counted 7 times more concussions than what were reported in the Junior hockey games that they researched

• 69% of concussions came from hits to the head

• 80% of those hits were intentional

• there is only a 7% reporting rate
• 90% of those with concussions did not lose consciousness

Dr. Echlin finished his lecture talking about management. A doctor must diagnose a concussion, not even your team trainer. If you believe that your athlete, son, or daughter has suffered a concussion do not leave them alone. Do not wake them up in the night (this will offset the healing process). And lastly and most important, if symptoms drastically worsen, take your player, child to the emergency department. The leading doctors (Echlin and Carson) instruct their concussion patients to go to “jail”, no TV, gaming devices, telephone, or computer. But be sure your athlete or child is not left too alone, as it is easy for them to slip into a depression. At the end of your concussion healing process, make sure to get a doctor to clear you for play.

The final two speakers at the symposium were two students that are patients of Dr. Echlin. The first girl was from Bishops University and she had the best line to sum up how those with concussions often feel. She explained: “Don’t ask (your teammate with a concussion) when they will be coming back to play”. So many athletes are sad and depressed about having to sit out and miss games, especially with an invisible injury that neuroscientists are only just starting to understand.

For more information about concussions here are some helpful links:

• www.thinkfirst.ca
• www.csro.com
• www.shootforacure.org
• www.athletictherapy.org
• Return to Play guidelines: see page 758

Jen Mark BSc., CAT(C), CSCS

www.dynamicliving.me

What to do if you feel injured?

Fall? What Fall?

At some point in everyone’s athletic career, there is an injury. For those that are working towards world championships or the Olympics, there is likely a staff of therapists and doctors around you giving you guidance on what to do once an injury occurs. But what if you just run a few days a week? What if you play pick up volleyball or lift weights at the local gym? Do you know what to do when something doesn’t feel right? When injury occurs?

The recently popular Mark Twain once said, “it is not what we know that does us harm, it’s what we know that just isn’t so”.

Let me tell you about a client of mine that runs half marathons recreationally. She slipped on the ice a few days ago while running in the snow. At the time, just her pride was hurt, and she was able to run home. After she had sat down for a while, she realized that her back was quite stiff and there was a pain in her glutes. The next morning the pain was a little worse and it changed the way she moved around the house and around the office that day.

What could have been done differently to prevent such stiffness and pain? What does she do now that the pain is there?

First to address the idea of prevention. After such a fall it is a great idea to get home and stretch. Get onto the floor and stretch anything that might already be sore, or areas that you think could get sore later. When you have a fall, usually your back takes a lot of stress and impact. Lying on your back and hugging your knees, pulling your legs across your body, and stretching your glutes will help minimize any spasms. If you think you might have sustained an injury, put ice on the painful area right away. Keeping the swelling down is important and this will promote healing.

Second, if you find that you do get stiff and sore after a fall, or even after playing a game of basketball with your friends, you can keep the pain and damage to a minimum. On the onset of pain and /or swelling apply ice. If there is only pain, put the ice on for about 15 minutes. You can do this once every hour if you have the time. If there is some swelling, you can add ice for 3 minutes, heat for 1 minute and repeat 4-5 times. Ice baths also help reduce pain and swelling. Sitting in a cold bathtub with ice cubes is a great delight I encourage you to try! The circulation of the water and the movement of your limbs helps to pump waste products out of your injured area and into your lymph system.

Stretching and icing before the pain starts and before swelling has a chance to clog up your joints, really helps. If it doesn’t, you need to get checked out by a professional. I find those that “wait to see what happens” always end up with a longer lasting injury. Getting treated right away may mean one treatment. If you wait and the problem persists, you may need weeks of treatment.

Think of the money you’ll be saving by taking care of your body right away. You’ll be back running, back dunking the ball, and back tobogganing with your children faster than you know it! Get to know your body and stop any injuries from getting in the way of life.

Back to my client that fell – we adjusted her pelvis levels and put her back into alignment. One day later she was doing a Zumba class at the local gym! Fall? What fall?

Jen Mark BSc., CAT(C), CSCS