Sports injuries are injuries that occur in athletic activities. They can result from acute trauma, or from overuse of a particular body part

Types of Heel Pain

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Many patients ask themselves, “Do I have plantar fasciitis?”. Many patients assume they have plantar fasciitis as it is a fairly well known term but there are many types of heel pain. The types of heel pain shown in the video below are the most common types of heel pain. Based on the location and the type of pain you are experiencing, it is easy to differentiate between let’s say plantar fasciitis or achilles tendonitis, plantar fasciitis or fat pad syndrome, etc. Once you have a proper diagnosis, then you can go about treatment for heel pain successfully.

What is Fat Pad Syndrome?

The most common condition we see that tricks patients into thinking they have plantar fasciitis is fat pad syndrome. Some patients can have both! There are a few key differences in the history and exam to differentiate between the two. Patients with fat pad syndrome have pain consistently throughout the day, worse barefoot, and stretching does not help. Plantar fasciitis is characterized by pain that is worse in the morning, but improves to a degree as you walk around. Stretching and rolling usually help temporarily alleviate symptoms. Fat pad syndrome needs to be protected with taping to support the fat pad, wearing heel cups in your shoes, and wearing cushioned shoes throughout the day. Once the heel is protected, inflammation will go away and the symptoms improve.

Types of Heel Pain

Is a Plantar Heel Spur the Cause of My Pain?

One question we often get asked is if a patient has plantar fasciitis or heel spur. The reality is, is that people may have heel spurs and never have pain in the heel. Or patients may have plantar fasciitis symptoms and find a bone spur after having an x-ray. Patients may experience plantar fasciitis pain with a heel spur or they may not.

A heel spur is only present if there has been enough tension or pulling from the plantar fascia. This constant tension results in the heel bone becoming elongated at the plantar fascia attachment site. This usually occurs from long standing tension in the plantar fascia from high arches, biomechanical stress, hallux limitus, etc. Treatment is same if a patient has plantar fasciitis or heel spur.

Achilles Spurs and Haglund’s Deformity

Heel spurs can also be seen on the back side of the heel where the Achilles tendon attaches. Achilles tendonitis can cause pain in the back of the heel. This type or Achilles tendinopathy is termed insertional Achilles tendonitis as the pain is at the site of where the tendon inserts into the heel bone. Similar to the plantar heel spur, some patients may have an Achilles heel spur, others may not. Treatment of insertional Achilles tendinitis, with or without a spur is the same.

A more obvious deformity called a Haglund’s deformity, is a overgrowth on the backside of the heel where the Achilles attaches. The tendon becomes inflamed when this deformity rubs on the soft tissues, especially in shoes. We most comonly see this in patients who have had chronic Achilles tendinopathy or have other structural causes of this deformity such as high arches, hallus limitus, and or rear foot varus

Less Common Types of Heel Pain

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Less common types of heel pain but still seen in the clinic are peroneal tendonitis and posterior tibialis tendonitis. Peroneal tendonitis can affect the outer portion of the heel while posterior tibialis tendonitis can affect the inner heel area. Usually the pain is at the sides of the heels but we have seen some cases where pain is on the bottom/side of the heel. Again patients are quick to say they have plantar fasciitis, but with a pinpoint exam, we can rule in these other tendons as being the pain generators, not the plantar fascia.

The heel is a small area and can be relatively simple to diagnose the cause(s) of heel pain. However, many people end up having different conditions than what they thought they had. This ultimately delays the recovery process by not receiving the correct treatment plan initially. Schedule with one of our sports chiropractors today to get you on the correct path to recovery. Peak Form Health Center is located in Mission Valley, San Diego.

Achilles Tendinitis Exercises San Diego

Achilles Tendinitis Exercises

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We demonstrate Achilles Tendinitis exercises in the video below. Achilles tendinitis exercises that focus on loading the Achilles tendon have been shown to have significant outcomes in pain and function. Many Achilles tendonitis rehab plans fall short by showing patients very low level exercises such as stretches and foam rolling. That is not to say those exercises are not helpful for a patient, they might be. With a successful achilles tendinopathy exercise program, we have find the most challenging strength exercises that patients do well. If a patient has been performing the same exercises for 12 weeks, they are not being challenged sufficiently!

Every achilles tendinopathy rehab program is different. A patient may start achilles tendon exercises at a different point than the next. It depends on the patient’s achilles tendonitis exercise tolerance to Achilles tendon loading and goals around the outcome of treatments. A sedentary individual with a goal of walking pain free will have a significantly different program from an in season college basketball player.

Example of Achilles Tendinitis Exercises

Achilles Tendinitis Exercises San Diego

A recent patient dealing with Achilles tendinitis is a high level amateur tennis player and plays pickleball for fun. She had Achilles tendinitis for 1 month, with prior history of multiple calf strains on that leg. She did not seek treatment as she thought the pain would subside. The pain slowly worsened until she was unable to play tennis and pickleball due to Achilles Pain.

Achilles Tendinitis Exam and Treatment

We went through a thorough Achilles tendinitis exam and treatment on the first visit. The lower leg with achilles tendinitis was significantly more weak than the other leg. For example, we performed a single leg calf raise endurance test. The uninjured leg, she performed 40 easily in 1 minute. On the injured side, she performed 20, with poor movement quality starting at 8! An important note, she felt some soreness but it did not get worse with challenging the tendon with exercise.

Challenge with Exercise

Knowing pain was not a limiting factor, we were able to prescribe daily, calf loading exercises to improve strength. This was the obvious improvement that was needed to help her injury. After 2 weeks, she showed significant improvement in pain. She was able to perform the same number of reps unbroken as the healthy leg at that point. At this point we progressed to dynamic exercises such as pogo hops, squat jumps, and four square hops. She had minor discomfort at first, but as she performed the plyometrics pain started to dissipate and confidence increased.

It was very important to keep progressing this tennis athlete quickly, and get her to more sport specific activities. This, with graduated return to play, will help avoid recurrence of Achilles injury, and avoid future injury.

If you are looking for a well rounded assessment and detailed treatment plan, schedule with us! Don’t let prior poor physical therapy for Achilles tendinitis deter you from finding the right treatment approach. Our team of sport chiropractors are trained to assess, treat, and prescribed exercises for achilles tendinitis and other causes of heel pain. We are located in Mission Valley, San Diego near the neighborhoods of La Jolla, Scripps Ranch, and Point Loma!

Achilles Tendinitis Treatment San Diego

Achilles Tendinitis Treatment

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What is Achilles Tendinitis and Tendinopathy?

When looking for Achilles tendinitis treatment, it is first important to understand the condition. Achilles tendinitis is characterized by pain, and sometimes swelling along the Achilles tendon. Achilles tendinosis is pain that has become chronic (lasting 3+ months). At this stage of the injury, the tendon begins to show degenerative changes. Achilles tendinopathy is more of an umbrella term for pain and dysfunction at the Achilles tendon. Achilles tendinopathy is a product of applying load to the tendon which exceeds the ability of the tendon to withstand load.

For example, a completely sedentary individual decides they want to start walking daily. They begin walking 5 miles per day up steep hills. After 3 weeks, they develop Achilles tendinitis in both lower legs. Why? The tendons were not in good condition with minimal activity demands, and then were put in a position of high strain (5 miles walks). Couple that with very minimal recovery between sessions (performing every day) and Achilles tendinitis may develop. If that same individual began their exercise program walking every other day, on flat ground starting with 10 minutes and slowly increasing the time of the walks, they would have likely have much more success in properly introducing strain to the tendons to avoid injury!

Achilles Tendinitis Treatment

Treatment Methods

Achilles tendinitis treatment generally consists of controlling the pain. Activity modification, NSAIDS, ice/heat, various manual therapy, and stretching to the calf muscles help with this aspect. In the video above, we discuss examination procedures for the Achilles and lower leg. We also show treatment options such as Active Release Technique for Achilles tendinitis, and Graston Technique for Achilles tendinitis. Active Release Technique involves identifying tight portions of the muscles that are causing excessive tension on the Achilles tendon. Once identified, the practitioner shortens the muscle, applies firm pressure and has the patient actively lengthen the muscle. This helps loosen the muscle, break down adhesions in the muscle fibers, and promotes blood flow for healing.

Graston technique for achilles tendinopathy involves using metal tools to rub along the Achilles tendon. This promotes blood flow to the the tendon which helps promote healing to the injured tendon. The manual treatments are designed to help decrease pain and allow the patient to strengthen the tendon successfully. For long term resolution of achilles tendinopathy, loading exercises are key.

Shockwave for Achilles Tendinitis

A new treatment modality has been shown to be effective at helping resolve chronic Achilles tendinopathy. Shockwave therapy utilizes high energy sounds waves which penetrate deep into the tissues. This results in improvement in blood flow, break down of scar tissue, and improve the healing response to the injured area. Read more about shockwave therapy here.

Shockwave Therapy for Achilles Tendinitis

Exercises for Tendinopathy

The most recent literature in the past several years shows that Achilles tendinitis treatment must include loading exercises to the Achilles tendon. Various eccentric, isometric, concentric loading exercises have been tested and shown to help decrease symptoms while strengthening the tendon/muscle complex. When Achilles tendonitis exercises are performed, it is ok to work through some pain. As the function of the muscles and tendons improve, the pain will begin to dissipate and not return. Achilles exercises take patience, and consistency but will help significantly with Achilles tendinitis symptoms. Ultimately, strengthening, and proper return to play will help avoid nagging Achilles tendinitis symptoms. Check out our achilles tendinitis exercise video for examples of progressions we use in the office.

Exercises for Achilles Tendinitis

Shockwave Therapy for Hamstring injury

High Hamstring Tendinopathy Treatment

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High hamstring tendinopathy is a condition that affects many different athletes. This type of injury is usually a result of repetitive strain, and affects many running athletes. Track running athletes, particularly hurdlers, are susceptible to high hamstring tendinopathy due to the large forceful range of motion required. Endurance runners are also susceptible due to the high volume of contractions the hamstring muscles undergo during training and racing. Usual treatment for high hamstring tendinopathy involve massage, Active Release Technique, Graston Technique, eccentric loading exercises (Nordic hamstring curls), and core strengthening.

Shockwave Therapy for High Hamstring Tendinopathy

In stubborn cases of high hamstring tendinopathy, we have been having great success with shockwave therapy. High hamstring tendinopathy treatment with shockwave therapy involves using shockwaves to stimulate a healing response at the affected hamstring tendon. Shockwave therapy has been shown to increase blood supply, activate dormant stem cells, break down trigger points, and loosen up scar tissue/calcifications at the injured site.

In chronic tendinopathy, the affected tendon has poor blood supply and physically starts deteriorating. The shockwaves stimulate the body’s healing response to the area to regenerate the damaged tendon. With weekly treatments, the beneficial inflammation/healing response reaches its peak to repair the damaged tissue.

Watch a shockwave treatment with one of our marathon runners who was dealing with nagging high hamstring tendinopathy.

After 4-8 weeks, most patients experience complete resolution of their high hamstring tendinopathy. Most importantly, patients do not need to avoid training while you are undergoing shockwave therapy treatments. In fact, it is important to load the hamstring with targeted strength exercises. Eccentric loading exercises such the Nordic hamstring curl are very effective at targeting the hamstrings. Even simple isometric exercises are enough to stimulate the tendon while it undergoes shockwave therapy. If you are interested in starting your shockwave therapy for high hamstring tendinopathy, schedule here. We also treat various other tendinopathies with shockwave therapy.

Golfer's elbow treatment San Diego

Golfer’s Elbow Treatment

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What is Golfer’s Elbow

Golfer’s elbow or medial epicondylitis is characterized by pain at the inner portion of the elbow. It is considered a repetitive strain injury and develops when load exceeds the current resiliency of the muscles and tendon. The flexor muscles (the muscles that help you make a fist), as well as the pronator teres muscle (helps us turn a doorknob) all share the common flexor tendon. The common flexor tendon attaches to the upper arm bone at the medial epicondyle. Conversely, tennis elbow is characterized by pain on the outer portion of the elbow.

With repetitive stress to the forearm muscles, the tendon bone attachment initially becomes inflamed resulting in pain. If left undiagnosed, the tendon no longer is inflamed and actually starts degenerating and is termed tendinopathy. Most cases of Golfer’s elbow affect patients for a long time so the more appropriate term is medial epicondylopathy. Check out our video below for a demonstration on the exam and treatment for Golfer’s elbow.

Who is Susceptible to Golfer’s Elbow?

As the name suggests, golfer’s commonly are affected by this condition due to the nature/impact of the golf swing. Any profession or activity that uses the hands at a high level are also very susceptible. Mechanics, software engineers, office employees, body builders, powerlifters, rock climbers, swimmers etc. all place a high amounts of load into the forearm muscles and can lead to medial epicondylopathy. Again, development of Golfer’s elbow is usually due to prolonged low grade strain tasks like using a screwdriver. But can also be from a shorter but more forceful strain such as golf swings/weight lifting etc.

Treatment for Medial Epicondylitis

Treatment is multifactorial to help get rid of nagging Golfer’s elbow and conservative management offers lasting results. Graston technique and Active Release Technique are therapies that help ease the pain and loosen up tight restricted muscles that cause Golfer’s elbow. While these offer relief from pain, strengthening area will allow for further resiliency of those tissues. Check out our video, Flexbar Exercises for Golfer’s Elbow, to find a demonstration of a flexbar for Golfer’s Elbow. With ongoing loading of the the tendon, permanent results will occur and patients will be pain free.

Medial epicondylitis treatment San Diego
Anatomy of the forearm musculature which causes medial epicondylitis

If you are dealing with elbow pain, please schedule with one of our sports chiropractors today. Click the “schedule now” tab above or call our office at 619-818-4306. We are conveniently located in Mission Valley, San Diego. We will evaluate, diagnose your elbow pain and get you on a proper treatment plan to help you get rid of Golfer’s elbow.

Peroneal tendonitis treatment san diego

Peroneal Tendonitis Treatment

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What is Peroneal Tendonitis?

Peroneal tendonitis is characterized by pain and tenderness on the outer part of the foot and ankle. In some cases, there can also be swelling around the tendons and tendon sheaths around the outer ankle. The two main peroneal muscles originate on the outer lower leg bone (fibula). The longer peroneal muscle runs around the outside of the ankle, and wraps around the side of the foot to the bottom of the foot and inserts into the midfoot (medial cuneiform) and the base of the 1st metatarsal. When these muscle become excessively tight, the tendons become inflamed, rub against the side of the ankle and foot which can become quite painful. Check out our video below describing our approach to treating peroneal tendonitis and continue reading below.

What are the Causes?

When the peroneal muscles sustain a higher load than what they are capable of handling, peroneal tendonitis can occur. Peroneal tendonitis can be a result of ankles sprains, repetitive strain (ballet dancing, jumping, running), people with high stiff arches in their feet, and from compensation due to other injuries (plantar fasciitis).

High stiff arches in the feet is often a presentation we see as this type of foot places more pressure on the outer half or outer third of the foot. This causes the peroneals to work much more strenuously than in feet with a more normal/flexible arches. Due to this weight distribution, these individuals are more prone to “rolling” their ankle during normal day to day walking and especially during sports (ex: Soccer). When looking at wear patterns on the bottom of shoes for a runner, we will see excessive where on the outer border of the bottom of the shoe. In many of the chronic cases of peroneal tendonitis, many patients do not know what “caused” the pain to start. When we go through a thorough exam and history, many patients have the history and characteristics described above which should be addressed for proper treatment.

Peroneal tendinopathy treatment san diego
High, stiff arches often time plays a role in the development of chronic peroneal tendonitis.

Conservative Treatment

Conservative treatment for peroneal tendonitis and peroneal tendinopathy is very successful for managing the symptoms. In our office, we usually start peroneal tendonitis treatment with Graston Technique to the peroneal muscles (The peroneous longus, peroneous brevis, and peroneous tertius) to help loosen up the muscles while promoting blood flow to the area. Active release technique, a type of myofascial release, for peroneal tendonitis may be helpful to break down adhesions and trigger points within the peroneal muscles. Most importantly, loading the peroneal muscles with proper strength training exercises will help stimulate the injured areas of the tendon while providing strengthening to avoid future reaggravation. Peroneal tendonitis rehab exercises are crucial to help the tendons heal properly.

Finding the Root Cause of Peroneal Tendonitis

In treating peroneal tendonitis, it is important to discover the root cause. As described above, if a patient has very stiff, high arches, this will place more of the body weight on the outer half of the foot which will overly stimulate the peroneal muscles. Another example is peroneal tendonitis due to hallux limitus (when the big toe has limited extension), patients will have a hard time shifting their weight towards their big toe during gait which keeps their weight on the outer half of the foot, loading the peroneal muscles excessively.

Other conditions such as plantar fasciitis can lead to peroneal tendonitis due to compensation. When the bottom of the inner heel is painful, patients unknowingly keep the weight of their body on the outer half of the foot to avoid pressing into the painful part of the heel; peroneal muscles again become strained resulting in peroneal tendonitis. Many of these patients experience outer heel pain while walking or outer heel pain while running. Another condition called cuboid syndrome causes peroneal tendonitis as the peroneal tendons run across a portion of the cuboid bone. When the cuboid bone is stiff and not moving well with cuboid syndrome, the peroneal tendons also become stiff resulting in pain.

If you are dealing with peroneal tendinopathy, please schedule with one of our sports chiropractors today. Above you will find the “schedule now” tab which will direct you to our online scheduler. You may also call our office at 619-818-4306.

Shockwave for Shoulder Pain San Diego

Shockwave for Shoulder Pain

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Shockwave for shoulder pain is becoming one of the leading therapies for treating chronic, unresolved shoulder pain. Many chronic shoulder conditions involve tendinosis of the rotator cuff. Tendinosis means that the tendon is beginning to degenerate due to chronic injury to the tendon. To help the tendon heal, shockwave for shoulder pain sends high energy sound waves deep into the affected tissues. These soundwaves cause irritation to the damaged tissues which results in the body perceiving that are as being “injured”. The body will then send growth factors to the area, release stem cells, increase capillary production so that the injured area can heal at a higher level.

Shockwave therapy has many benefits. It often will reduce pain and increase mobility immediately after the first treatment. Typical treatment protocols involve 4-6 treatments at 1 treatment per week. This accumulation of treatment ignites the bodies natural healing response to repair the damaged tissues. Our office uses the most advanced shockwave equipment from Kinas medical, the leader in shockwave technology.

Check Out Our Treatment Video Below

Our patient has been dealing with rotator cuff tendinosis. Traditional Physical Therapy, Graston Technique, and Active Release Technique offered only short term improvement before pain returned. The video shows his 4th shockwave treatment and has noticed significant improvement!

Shockwave San Diego

After the last shockwave for shoulder pain treatment, we wait 4-6 additional weeks to continue to allow the healing process to occur. Other treatment options for shoulder pain, frozen shoulder, rotator cuff tendinopathies include PRP injections, cortisone shots, Graston Technique, Physical Therapy exercises, and Active Release Technique. We find that shockwave therapy offers fast, efficient treatment that is cost effective for our patients. PRP injections also utilize the body’s own healing response however each treatment ranges from $500-$1,500 per treatment and often requires multiple rounds of injections. PRP injections are also known to be quite painful for the patient while shockwave treatments are generally much more mild.

Can Shockwave Therapy Help with all Shoulder Conditions?

In general, shockwave therapy is very effective for long standing injuries lasting longer than 6 months. It is effective at stimulating the body’s healing response, breaking down scar tissue, and eliminating trigger points. All of which helps with decrease pain and increase range of motion. Shockwave therapy for frozen shoulder is particularly effective because the sound waves can penetrate deep into the shoulder joint where the adhesions in frozen shoulder are found. Many patients who receive shockwave therapy for frozen shoulder see immediate improvement in pain and range of motion!

Are you interested in shockwave therapy for shoulder pain? Schedule with our sports chiropractors at our shockwave clinic, Peak Form Health Center! We are conveniently located in Mission Valley, San Diego. We are one of the few sports injury clinics that offer shockwave therapy for sports injuries.

Home Treatment fr Plantar Fasciitis

Home Treatment for Plantar Fasciitis

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Plantar Fasciitis can be a frustrating condition to deal with for both the patient and the practitioner. While challenging, we have seen excellent results in resolving plantar fasciitis at our San Diego sports injury clinic. The combination of Graston/Active Release Technique combined with specific home treatment for plantar fasciitis work well to eliminate it for good! Keep reading for our home treatment for plantar fasciitis strategies and check our our Youtube video.

4 Phase Home Treatment for Plantar Fasciitis

  1. Stretch and Mobilize– Foam rolling, lacrosse ball massage, and specific stretches are primarily used in this treatment phase. The goal is to alleviate tension that may be causing pain, faulty biomechanics, and other compensations.
  2. Plantar Fasciitis Specific Strengthening– Foot exercises are used to help strengthen the intrinsic muscles of the foot to help support the arch, foot, and ankle. Eccentric lower leg exercises are prescribed to help stretch and strengthen the surrounding tissue. Research has shown that eccentric loading exercises for plantar fasciitis has significant benefit.
  3. Global Strengthening- As symptoms improve, it is important to work on strength and balance moving up the lower extremity. Typically this involves core, hip, posterior chain strengthening to support the entire leg.
  4. Sport Specific Strategies- Depending on the sport or activity, sport specific strategies are necessary for successful “return to play”. For example, as a runner, you will want to build endurance in the tissues before returning to quick explosive speed work.

Managing Symptoms During the 4 Phase Approach

There are many different devices, that can help minimize symptoms while performing home treatment for plantar fasciitis. In our article 7 Ways to Treat Plantar Fasciitis at Home, we discuss these strategies in detail. In summary, stretching and supportive devices can minimize the painful symptoms. The more normal you can move around your heel, the less strain your body will experience.

Introduction to Home Treatment for Plantar Fasciitis

Watch our Youtube video describing our strategies mentioned above. Don’t forget to subscribe to our channel! We

Follow along with our next blog post, Stretch and Mobilize Plantar Fasciitis, for the specific exercises we use with our patients to eliminate plantar fasciitis!

Are you looking for a provider to help with your heel pain? Peak Form Health Center has the sport doctors that can help! We are conveniently located in Mission Valley, San Diego near the neighborhoods of UTC, La Jolla, Normal Heights, Hill Crest, Mission Hills, and Kensington.

Treat Tennis Elbow at Home

Top Tips to Treat Tennis Elbow at Home

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When you treat tennis elbow at home it will often help significantly reduce the amount of time this painful condition persists. At home, using a combination of pain relieving gels, taping/strapping, myofascial release, and specific exercises, tennis elbow will improve.

Lateral epicondylitis, or more commonly “Tennis Elbow”, is a painful tendinopathy that affects the outer elbow. It is considered an over-use injury to the extensor muscles of the forearm. The extensor muscles of the forearm connect into a common tendon which inserts into the bony part of the outer elbow. With excessive use the muscles tighten and pull at the outer elbow. Pain can be sharp, achy, and fairly constant.

*The following tips are general recommendations. We highly recommend seeking the advice of a qualified healthcare provider to provide a diagnosis and proper treatment plan.

Common Causes of Tennis Elbow are as follows:

  • Playing tennis
  • Excessive computer use (typing)
  • Rock Climbing
  • Repetitive wrenching (mechanics, plumbers)
  • Jiu Jitsu
  • Excessive weight training

Tips to Treat Tennis Elbow at Home

  1. Armaid Foam Massage Tool – The Armaid is a self myofascial release tool designed to break down tight muscles of the forearm. It comes with a number of different attachments to isolate myofascial adhesions (scar tissue) and break them down. With consistent use, the muscles will begin to regain their normal flexibility which will relieve pressure from the painful elbow insertion. This device, in our opinion, is one of the best devices you can use for treating tennis elbow at home. It is especially useful if you participate in a job/sport that causes a lot of strain into the forearm muscles.
    This device is excellent not only for treating tennis elbow at home but for treating “Golfer’s Elbow” which affects the opposite side of the elbow. Watch Dr. Rose demonstrate how to use the Armaid in our video below.
  2. TheraBand FlexBar, Tennis Elbow Therapy – The FlexBar is a flexible bar with grip ridges that allows the bar to twist. The exercise performed is an eccentric load to the extensor muscle group of the forearm. Eccentric loading has been shown in research to strengthen damaged tendons and stretch the muscle fibers. The FlexBar accomplishes this by having the patient grab the bar with the wrist down, and twist the bar up so the wrist is now up. Slowly release to perform the eccentric contraction. Watch Dr. Rose demonstrate this treatment for tennis elbow at home. It can be a little confusing when you start!
  3. RockTape– RockTape is a brand of kinesiology tape. It is designed to support muscle strains, joint sprains, and proper movement mechancis. To treat Tennis Elbow at home, it helps by supporting the extensor muscle group, and the cross strap before the elbow, helps absorb forces from traveling to the painful point on the elbow.
    Treat Tennis Elbow at home
    We prefer rock tape for one simple reason, it just seems to stick better than other brands. It can also be used in conjunction with RockTape’s Rock Sauce Hot and RockSauce Ice, depend if you prefer hot or cold sensations. You put RockSauce on first to which helps remove oils from the skin and you get the benefit of pain relieving effects of hot or cold sensations. You can then apply the Rocktape to the same area.
  4. Biofreeze Pain Relief Gel– Another option to RockSauce. We recommend Biofreeze Pain Relief Gel as it is one of the stronger topical pain relieving gels you can get. It is a product we use daily in our office and can be great for treating tennis elbow at home. Just apply a dime sized portion all around the elbow to help with pain.
  5. Simien Tennis Elbow Brace– A Tennis Elbow Brace can work well for in a couple different scenarios. First, when Tennis Elbow is affecting day to day activities such as opening doors, cooking, shaking hands. Second, when you still need to train or compete at a high level for a competition. The brace works by compressing the tendon right before the insertion point which is the most painful. When forces travel up the forearm, they get dispersed at the site of the brace, minimizing the amount of force that travels all the way to the painful point. Ideally, we want to treat and work tennis elbow to get rid of the symptoms, but this works well to treat tennis elbow at home when dealing with pain.
  6. Muscle Floss AKA Voodoo Floss– Muscle Flossing is a relatively new treatment method for various conditions. It can be a great too to treat Tennis Elbow at home. Muscle flossing works through ischemic compression with rapid blood release into the injured area.
    To explain further, you tightly wrap the elastic band around the elbow. You want to the band to be pretty tight to where it is mildly challenging to bend the elbow. For 30-60 seconds, bend then elbow back and forth, and move the wrist up and down. The band restricts blood flow to the area and movement pumps blood out of the area. You then rapidly release the band which releases rapid blood flow to the area.
    The idea is, this rapid injection of blood to the injured area will help increase the healing process to the tissue. In the pictures below, you can see the elbow is red due to blood flow after 30 seconds of elbow motion.
    treat tennis elbow at home
    treat tennis elbow at home

Those were the top tips we give to patients to help treat tennis elbow at home. We recommend these tips with in person treatment to help fix tennis elbow effectively and quickly. Countless cases of tennis elbow have been treated in our Mission Valley, San Diego office. We primarily use Active Release Techinque, Graston Technique, exercises and a combination of the above tips to treat tennis elbow at our office. Our office is near the neighborhoods of Pacific Beach, UTC, La Jolla, Clairemont Mesa, Santee, La Mesa, Kensington, North Park and South Park.

Runner's Knee Treatment San Diego

Runner’s Knee Treatment |San Diego

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Runner’s Knee Treatment | San Diego

Patellofemoral pain syndrome, aka runner’s knee, is characterized by achy, dull pain generally around the front of the knee. Runner’s knee is a common type of running injury that we see in our San Diego running injury clinic. With a combination of manual therapy, exercise, and run program modification, the runner returns to running pain free. Let’s take a look at common symptoms/causes of runner’s knee and the treatments that will get you back to running pain free.

Symptoms

Most runners will feel dull, achy pain diffusely around the front of the knee. The pain may favor the outer front or the inner front of the knee. It is usually worse with longer or down hill runs. Sitting for long periods usually increases tightness and soreness around the knee. Stretching often makes the knee feel better.

Runner's Knee Treatment San Diego

Common Causes of Runner’s Knee

Here are the most common causes for developing runner’s knee.

  1. Running Form– Many runners, beginner through experienced, have running form flaws that create excessive tension at the knees. Common culprits are running with a low cadence, over striding, running with a crossover gait, and poor posture. Read our blogs for more information: Increase Your Cadence!, Do You Run With a Cross-Over Gait?, Improve Running Posture.
  2. Performing “Too much, Too Soon”– This is what most commonly affects newer runners. They begin training for their first 5k, 10k, or half marathon and start running too many miles with too little recover. The tissues do not have enough time to heal between running sessions, and eventually injury results.
  3. Training Error– If a runner drastically changes their training, runner’s knee can develop. Adding significant amounts of hill training, particularly running down hill, is the most common training error that can cause or exacerbate runner’s knee.
  4. Muscular Imbalance– Runners who are excessively tight in the quadriceps muscles are prone to developing discomfort in their knees. Keeping up with a stretching regimen will help ease the symptoms.
  5. Older Age– Older runners tend to have some decrease in joint space due to wearing down of the tissues over the years. When the joint between the knee cap and knee wears down, there is more compression at the cartilage which can cause swelling and irritation of the local tissues. Every hear cracking, popping , or tearing when walking up and down stairs or with squats? Those are signs of cartilage wear called crepitus.

Runner’s Knee Treatment San Diego

Treatment for Runner’s knee involves 4 main approaches. The first is to address the injured tissue using Active Release Technique and Graston Technique. Active Release Technique for runner’s knee is effective at breaking down tight scar tissue around the knee. The second, using a running gait analysis to identify and correct common running form errors. Check out our full gait analysis for our patient with runner’s knee here: Runner’s Knee Case Study. The third is to modify the run training plan. Proper periodization is critical when coming back from injury. The goal is to modify certain factors (ex: terrain) that are known to irritate the knee. The fourth is to add strength training to the supporting muscle groups. This will provide more support, resist strain, and ultimately decrease chance of developing a running injury.

If you are experiencing pain in the front of the knee, you may be dealing with runner’s knee. It is important that you get the knee evaluated to get a proper diagnosis. This will help develop a correct treatment plan. Each person may benefit from slightly different approaches. The exercises and training modifications given to each patient are unique to the individual.

Our office is located in Mission Valley, San Diego near Normal Heights, La Mesa, Hill Crest, Point loma, Bay Park, Clairemont, Pacific Beach, and Bird Rock. Schedule online with one of our sports chiropractors today. We will help you get back to running pain free!