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

Hip pain running doctor San Diego

Types of Hip Pain and Running

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The hips play an important role during running. Running is essentially a single legged sport once you break down the movement.  The hip not only helps propel the body forward but also is a stabilizer of the lower back and the leg during the gait cycle. Due to the demands placed on the hip, it is susceptible to overuse, and acute running injuries. A running doctor can help by diagnosing the problem correctly and developing a treatment plan to get you back to running pain free.

Common types of hip injuries found in runners

There are many types of running injuries that can occur at the hip. Pain may be felt in the front, outside,inside, or back of the hip. Certain cases runner’s will describe the pain as deep in the hip joint. We will categorize the most common types of injuries we see based on location of the injury:

Front hip pain in runners

  • Hip flexor strain
  • Rectus Femoris/quadricep strain
  • Iliopsoas bursitis
  • Iliopsoas tendinitis/tendinosis
  • Rectus femoris tendinitis/tendinosis
  • Hip impingement
  • Hip labral tear
  • Stress reaction/stress fracture
  • Hernia

Outside hip pain in runners

  • Gluteus Medius tendinopathy
  • Iliotibial band syndrome
  • TFL strain
  • Trochanteric bursitis

Inside hip pain in runners

  • Adductor strain
  • Adductor tendinopathy
  • Iliopsoas tendinopathy
  • Hip impingement
  • Hernia

Back hip pain in runners

  • Hip osteoarthritis
  • Hip labral tear
  • Gluteal muscle strain
  • High Hamstring injury
  • Piriformis syndrome
  • Low back pain referral
  • Sciatica

To complicate the injury spectrum, there are cases where runners feel pain in the hip but is a referral from joint/nerve impingement from the lower back. Also if the hip is weak and injured, other injuries to the lower back, knee, shin, and foot may become prominent. Receiving a diagnosis from a running doctor trained in diagnosing and treating runners is very important.

Hip pain treatment

Our sports chiropractors at our Mission Valley office are trained to treat a wide variety of running injuries. We specialize in Active Release Technique, Graston technique, running form analysis, and rehabilitative/performance exercise. Schedule today to get evaluated by a running doctor who knows how to get your training back on track!

Knee Pain Running Doctor

Anterior Knee Pain and Running

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Pain in front of the knee is a common complaint that runners seek advice for from a running doctor. There are many conditions that can cause anterior knee pain including:

  • Patellar tendinitis/tendinosis
  • chondromalacia
  • Patella tracking issues
  • Quadriceps strain
  • Hip flexor strain
  • Capusular ligament sprain
  • Meniscus injury
  • Fat pad syndrome
  • Osgood Schlatter’s disease

It is important to seek treatment from a sports physician and running doctor to get a correct diagnosis, and begin correct treatment immediately.

Knee pain running doctor San Diego

What to expect at your appointment

At our Mission Valley office, our running doctor will take a thorough history of the running injury. After the history is completed an exam will occur which will include some or all of the following: range of motion, orthopedic, neurologic, functional movement, and strength/endurance tests.

Gait analysis is another important aspect for certain running conditions. We currently offer remote gait analysis where current patients can take a treadmill video of themselves running, then email it to our running doctor for evaluation. General recommendations for running technique can be found on our blog here: Increase your Cadence, and Improve Running Posture

Treatment for anterior knee pain

A combination of Active Release Technique, Graston Technique, and a home exercise program resolves many cases of anterior knee pain. We see significant results within 4-8 visits. Our goal is to our runners back to running pain free as soon as possible and have exercises to do to prevent the injury from reoccurring.

If you have been dealing with anterior knee pain during your training, please call our Mission valley office to schedule today. Our running doctors are certified to treat running injuries and get you back to running pain free fast!

Dr. Travis Rose DC is a certified health professional through The Running Clinic. Both Dr. Kevin Rose DC DACBSP and Dr. Travis Rose DC CCSP have treated hundreds of runners including Boston marathon qualifiers, and Olympic trial marathon runners.

Running Doctor Running Injuries San Diego

Running Injuries Treated in Mission Valley, San Diego

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Your training plan was going well and then out of nowhere, pain and discomfort pops up. At first you think, “Well it’s pretty minor, probably just a little sore from the weekend workouts.” So running continues as normal. Each run becomes more and more painful until the injury now hurts before, during, and after runs. This is when patients begin to search for a running doctor in San Diego to help recover from the injury. Our doctors of chiropractic are certified to treat sports and running injuries at our Mission Valley clinic.

What to expect for your running injury evaluation

Our running doctor will go through a thorough history of the injury first and then perform an exam which includes: range of motion, orthopedic, neurologic, functional movement and strength/endurance testing. If special tests are needed (x-ray, MRI), they will be ordered to help with a proper diagnosis.

Running injuries we treat

Runners seek treatment from a running doctor to specifically treat their injury. We treat the following conditions at our Mission Valley running injury clinic:

  • Runners knee
  • Quadriceps tendinitis
  • Hip bursitis
  • IT band syndrome
  • Hip impingement
  • Chondromalacia
  • Shin splints
  • Plantar fasciitis
  • Heel pain
  • Metatarsalgia
  • Morton’s Neuroma
  • Hallux limitus/rigidus
  • Posterior tibialis tendinopathy
  • Peroneal tendinopathy
  • Low back pain
  • Sciatica
  • Hamstring tendinopathy
  • Muscle strains

San Diego Sports Chiropratic

Treatment

Majority of running injuries are a result of overuse, with not enough rest which results in eventual injury (muscle strain, tendinitis, periostitis). Specific interventions to the affected area will help speed up the recovery process. These treatments may include:

Seeking the help from a running doctor specifically, will help get you back to running pain free faster. Schedule with one of our sports chiropractors today at our clinic in Mission Valley San Diego!

Shin Splints treatment San Diego

Shin Splints and Running

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Shin splints can be a frustrating condition to deal with. There are two types: anterior and posterior shin splints. Anterior shin splints are more common in beginner runners and doing “too much too soon” when starting a running training plan.  Posterior shin splints are more common in over trained runners; too much load over time, and/or too much intensity without proper recovery. Running form and technique can play a HUGE roll in recurring shin pain. We will mainly focus on discussing posterior shin splints as this is the most common condition we treat at our San Diego running injury clinic.

Do You have Shin Splints?

Shin splints are characterized by pain along the inner shin bone. In minor cases it may only hurt before and after runs. In more chronic or severe cases, it may hurt before, get worse during, and then be quite debilitating afterward. It is important to get evaluated by a sports chiropractor to rule out more serious conditions such as: chronic exertional compartment syndrome, stress fracture, and calf tear.

Why does the shin hurt with shin splints

The lower leg muscles attach to the tibia (shin bone) and run down to the heel and bottom of the foot. They act as shock absorbers during walking, running, jumping, etc. When these muscles contract, they pull on their bony attachments. If the muscles are not strong enough to absorb the shock well, the pulling at the attachments sites increase. Add in inadequate recovery after workouts, the tissues will not regenerate and will begin to fail. This will lead to soreness, pain, and inflammation along the inner shin where the muscles attach.

What causes shin splints?

Many times we see shin splints due to a recent change in training; change in volume, intensity, terrain, shoes, etc. For example, going from running 30 miles a week to then running 50 miles the next week. The interesting part is that many runners will not recognize this and state, “My training is great! I’ve had no issues until I ran 6 miles yesterday and had pain during and after the run.” It was not the 6 mile run that led to the shin splints, it was the 20 mile jump in volume the week before!

Many runners are susceptible to developing shin splints due to past injury to the lower leg muscles, poor running form, weak core muscles, weak lower leg muscles. When screening an athlete with shin splints, our running doctor will look at all of these potential causes  of shin splints.

But you said most cases are due to training error?

Correct, but if you have deficiencies mentioned above, your body will not be able to handle the forces involved in running as well, and failure will occur at a certain point. We see this a lot when patients have recurring shin pain season after season, or they develop pain only if they do speed work, or only if they run more than 25 miles per week. Their bodies are simply not strong enough to support the increased demands they ask of it. Or their running style puts more strain on the lower leg muscles; see our post on cross-over gait.

Treatment

Short term relief of shin splints involves: potential rest, Active Release Technique, Graston Technique, and home exercises. We see excellent results when we treat shin splints with Active Release technique to break down tight sore muscles that are irritating the bone. A rehab schedule will be advised so patients know when and how far to run. We typically see significant reduction in symptoms within 4-8 visits.

ART shin splints

Long term relief involves: correcting running form, correcting muscle imbalances in the lower leg, strengthening the core, and following a well periodized training plan every season.

We have worked with countless runners dealing with shin pain at our sports injury clinic in Mission Valley. It is important to have a running doctor correctly diagnosis your injury so a custom treatment plan can get you out of pain fast!

 

Dr. Travis Rose, DC CCSP and Dr. Kevin Rose, DC CCSP are Sports Chiropractors who practice in Mission Valley, San Diego.

 

Overcoming Lower Back Pain with Chiropractic

Different Types of Low Back Pain

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Common Causes of Low Back Pain

Low back pain is a very common issue experienced by the the general population at some point in life. Estimates vary but on average, about 38% of the general population experience low back pain in a year period.(2) Low back injury symptoms include: localized soreness, stiffness, and pain, radiating pain (pain into lower extremity), and possibly tingling and numbness into the lower extremity. The focus of this post will look at the common low back conditions we treat at our Mission Valley office.

First and foremost, we recommend seeking professional help from a certified sports chiropractor to correctly diagnose the low back injury. At our San Diego based sports injury clinic, we have seen many joint and disc injuries previously diagnosed as a “muscle strain” by a different provider. Simple diagnoses do patients no favors and will likely cause further harm!

Disc Injury

Let’s start by discussing what I would consider the most time intensive injury to resolve. Disc injuries have the following characteristics: occur in younger people (20-40 year old), common in athletes, associated with a memorable mechanism of injury (squatted and felt a “pop” in back), recurring back injury, worse with bending forward, muscle spasming, pain in the back with cough/sneeze/bowel movement, may have radiating pain (sciatica), and may have numbness/tingling in the lower extremities.

Joint pain

Lower back joint pain is characterized by the following: occurs in middle aged to older individuals (40-65+) with no mechanism of injury (gradually worsened) or younger people with a mechanism of injury (football player tackled in low back), worse when bending backward, sharp localized pain in low back, muscle spasming, possible pain into buttocks/thigh. The image below shows healthy low back joints. They can be injured with hyper extension or excessive bending through the spine

Piriformis Syndrome

Piriformis syndrome may be from acute spasming of the piriformis muscle (muscle runs from the tail bone to the outer hip) or from chronic tightening of the muscle. It is characterized by: pain in the buttocks, single sided sciatic symptoms, worse with sitting, no low back pain, worse with stretching hamstrings, and painful “knots” in the gluteal muscles/piriformis muscle. It is often misdiagnosed as a back related issue due to the symptoms of pain traveling down the leg. Check out our more thorough blog posts on piriformis syndrome found here: Piriformis Syndrome: Overview and Causes, Piriformis Syndrome Part II- Evaluation, and Piriformis Syndrome Part III- Treatment.

Piriformis Syndrome low back pain

Low Back Muscle Strain

Please reread disc and joint causes of back pain. Both cause low back muscle spasming or muscles “locking up”. This is why doctors not certified to treat sport injuries diagnosis many low back injuries as a muscle strains. Technically they are not wrong because low back muscles are usually strained or spasmed when the deep structures (disc/joint) are injured. If you see a provider and they do not perform an evaluation including range of motion, orthopedic/neurological testing, and palpating (physically touching your back), get a second opinion. Once more serious conditions are ruled out, low back muscle strains are usually: local to the low back, muscle is sore/tight to touch, usually injured due to quick movements, and back muscles are often weak.

Special Types of Low Back Pain

Athletes with low back pain, especially in particular types of sports that involve repeated bending through the spine, may develop significant low back pain. Small fractures or stress reactions can occur to the pars interarticularis; a small portion of the vertebrea that when fracture can cause spondylolisthesis. Other injuries can involve the disc herniating into the end plate of the vertebral body of the low back. These types of injuries are confirmed with imaging (x-ray, MRI) but can be considered as a working diagnosis based on a thorough history and physical exam. If you have a sport related low back pain, please get evaluated by one of our Mission Valley sports chiropractors.

Treatment

In a recent review article discussing conservative management of low back pain, several methods are described as primary treatment choices for acute and chronic low back pain. For acute low back pain, chronic low back pain, and chronic low back pain with leg pain, a trial of spinal manipulative therapy with supplementary treatments such as exercise, massage, and patient education is recommended.(1) Specific types of exercises are prescribed based on the practitioner’s experience and patient’s tolerance. In other words, each person with low back pain may receive different exercises based on their presenting symptoms. Decreased pain and symptoms we found after short term (1-3 months) and long term (6-12 months) follow ups.
Initial treatment for low back pain is recommended between 4-8 visits over a 4 week period. (1)

Low back pain sports chiropractor

At our office in Mission Valley, we customize treatment plans for each and every low back pain patient we see. For example, if a patient has a diagnosed disc injury in their back, extension based exercises for the low back may offer significant relief for one patient, yet cause terrible pain in the next patient with the exact diagnosis. Evaluation in person by a certified sports chiropractor will be able to determine the correct treatment approach. We utilize the latest techniques including spinal manipulative therapy, Active Release Technique, Graston Technique, and rehabilitative exercise.

References
Brussieres, A. E. et al. (2018). Spinal manipulative therapy and other conservative treatments for low back pain: a guideline from the canadian chiropractic guideline initiative. Journal of Manipulative and Physiological Therapeutics. 0 (0), 1-29.
Hoy, D. et al. (2010). The epidemiology of low back pain. Best Practice and Research Clinical Rheumatology. 24 (5), 769-781.

San Diego Sports Chiropratic

Benefits of Sports Chiropractic

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Sports Chiropractic Mission Valley San Diego

Sports Chiropractic Benefits

In general, chiropractic care is excellent for treating many different muskuloskeletal conditions. Many people also seek sports chiropractic care to recover from sport related injury, improve sport performance and avoid potential re-injury through regular maintenance visits. Unfortunately, not all chiropractors are trained to specifically diagnose and treat sport related injuries. If you are seeking care for a sports injury, it is important to know how to find a chiropractor who specializes in treating sport injuries.

Sports Chiropractic Board CertificationDACBSP Certfified

There are two main sport chiropractic certification courses that chiropractors can take after graduating chiropractic college. Both certifications are governed by the American Chiropractic Board of Sports Physicians (ACBSP). The first certification is a Certified Chiropractic Sports Physician® (CCSP®) which is a 100 hour post graduate program designed to educate chiropractors in the most common sports injuries and best practices to treat them.  Successful completion of the program requires a passing score of 250 question multiple-choice questions. The second certification is a Diplomate American Chiropractic Board Sports Physicians® (DACBSP®) is a continuation of the CCSP® program with an additional 100 hours of field training with a research project, and requires successful completion of both a written and practical examination. A sports chiropractor will have either the CCSP® or DACBSP designation behind their name.

Treatment Types

A sports chiropractor is trained in many manual and passive therapies to help an athlete recover from injury and prevent future injury. Our Sports Chiropractors at our office in Mission Valley offer the following therapies and modalities:

  1. Joint manipulation/mobilization– Restores proper range of motion and function to an injured joint.
  2. Muscle Stimulation– Electricity is transmitted via pads to the muscles surrounding the injured area. This helps loosen muscles, and increase blood flow to the area.
  3. Active Release Technique– Active Release technique is the “gold standard” in soft tissue treatment. It helps break down scar tissue that developed from acute trauma or chronic micro trauma to a structure.
  4. Graston Technique– Graston utilizes a set of stainless steel instruments to break down scar tissue in the muscles and the fascia that surrounds the muscles.
  5. Therapeutic taping– RockTape is used in our office to promote body awareness in a dysfunctional area and to support injured tissues during athletic competition
  6. Therapeutic exercise– Flexibility, mobility, strength, endurance, etc. exercises are given to each patient for specific goals in the treatment.
  7. Training advice– A progressive return of the athlete to their sport is vital for the full recovery from injury.

Sports Chiropractic at Peak Form Health Center Mission Valley

Our sports chiropractors at our Mission Valley office are board certified to treat sport related injuries. We treat athletes of all abilities, from the weekend warrior to the professional athlete. We are also athletes ourselves, and understand the importance of feeling your best for optimal performance. Our office is conveniently located off the Texas Street exit in Mission Valley. Please schedule today to get your training back on track and perform at your highest level!

Sports Chiropractor Ironman

Sports Chiropractic Baseball

Dr. Travis Rose, DC CCSP (Left) is an accomplished Ironman Triathlete. Dr. Rose successfuly completed the Ironman World Championship in Kona Hawaii 2017.

Dr. Kevin Rose, DC DACBSP (Right) is a former professional baseball player. Dr. Rose pitched for the Philadelphia Phillies organization.

 

 

 

What is Chiropractic Care?

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What is Chiropractic Care?

Chiropractors are trained to evaluate, diagnose and treat neuromuscular and musckuloskeletal conditions. It is a common misconception that chiropractors only treat spinal conditions with spinal manipulative therapy, or adjusting techniques. In fact, chiropractors treat a wide array of muskuloskeletal conditions which include neck pain, back pain, and headaches but also tendon disorders, muscle strains, and ligament sprains which commonly affect our upper/lower extremities. In our Mission Valley, San Diego office, we commonly treat soft tissue injuries with a combination of joint manipulation, Active Release Technique, Graston Technique, and rehabilitative exercise.

What to Expect for your First Visit?

History

There are a few forms to be filled out that answer questions regarding your current injury (or reason seeking care) and past health issues. One of our chiropractors will then go over this information with you and ask a series of questions regarding your current and past injuries; this helps give us information that leads to a working diagnosis.

Exam

Pain Fighting Exercises

After the history is complete, a physical exam is performed. This normally includes: active/passive range of motion, orthopedic testing, neurological testing, and functional tests such as squats/lunges. All these tests give us further information to accurately diagnose the condition that you are presenting with. This in turn will develop an appropriate treatment plan moving forward. In some cases, the history and exam may reveal a condition that is in need of further testing (X-ray, MRI) before treatment can begin. In rare cases, a referral to a specialized health care provider is warranted.

Many of our patients at our Mission Valley office seek out our care for sport performance and are not currently injured. In these cases, we focus on evaluating musculoskeletal imbalances that may be limiting sport performance.

Treatment

As mentioned above we utilize the latest therapies and treatment protocols for each injury we see in our office. Treatment may include some or all of the following:

                                          Active Release Technique Mission Valley

  1. Joint manipulation/mobilization- If it is determined that there is loss in range of motion at a joint, joint manipulation or mobilization can be performed to restore proper range of motion and joint function   
  2. Active Release Technique– Active Release Technique or (A.R.T) is considered the “Gold Standard” for treating soft tissue injury. The practitioner identifies the injured structure, applies pressure, and has the patient perform active movements. This helps break down scar tissue and restore proper function to the soft tissue. Treatments usually last 5-15 minutes and can be painful in areas where the injury is.
  3. Graston Technique– Graston is another technique we use in our Mission Valley office that helps break down scar tissue in the superficial layers of muscle and fascia in our body. Graston is also excellent for treating chronic injuries due to its ability to increase blood flow to the injured area. After treatment, you may notice red marks and feel warm in the area due to this increase in blood flow.
  4. Rehabilitative Exercise– An individual exercise plan is prescribed for each patient. Exercises may include flexibility, mobility, strength, stability, etc.depending on your injury and or goals with care. Our goal is to always keep the exercises progressive to avoid plateaus in care.

 graston technique in san diego Active Release Technique Mission Valley

 

Our goal is return patients to their sport, activity, job as quickly as possible, pain free. We often see significant results between 4-8 visits, depending on the severity of the condition. Once a patient has reached maximal improvement for the condition we recommend periodic check ups to re-evaluate the area. This allows us the opportunity to offer further advice, change exercises, etc. to avoid future re-injury. 

Please do not hesitate to contact our Mission Valley office at 619-818-4306 if you have any questions. You may call our office or visit our website to schedule today! We accept most major insurances, offer affordable cash rates, and offer a military discount for treatments.

Walking Hip Hike for Running

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Walking Hip Hike for Running

Running is essentially a one legged sport when you break it down. One leg touches the ground, supports the body moving forward, and then lifts as the second leg touches down. The walking hip hike drill shown below is great for the following: activate glute stabilizing muscles, improve single leg balance, develop hip/low back control with movement. This is great as a accessory drill for running in general and really good to work on if you suffer from a cross-over gait. Find more information on cross-over gait on our blog: Do you run with a Cross-Over Gait? and Cross over gait Correction.

I recommend performing this drill as a warm up exercise before running. This will activate the stabilizing glute muscles to help build awareness to those muscles during the run. Start by performing 10 steps on each leg before the start of each run. If you are a new runner or trying to fix a cross-over gait, perform this drill daily, with and without runs to develop a stronger mind body connection to those muscle groups.  If you find this drill to be too challenging, try performing other glute activation drill such as a bridge, clam shell, and side lying leg raise.

 

Weakness to these muscle groups can lead to a number of musculoskeletal issues. Injuries may include low back pain, hip bursitis, IT band syndrome, and shin splints. The hip hike walk will help decrease your chance for developing these injuries or will stop these injuries from reoccurring. Are you already injured? Please schedule with us today to get your running program back on track. We offer the latest treatment methods including: Active Release Technique, Graston technique, Sports Chiropractic, and are certified by The Running Clinic to treat runners and running related injuries!

IT band syndrome exercises san diego

Cross-Over Gait Correction

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How to Fix a Cross-Over Gait

The best way to work on cross–over gait is to perform running drills! Many runners are simply unaware that they run with a cross-over gait. Specific running drills to address a this type of gait will significantly improve running efficiency and decrease risk for injury. At our Mission Valley sports injury clinic, we stress the importance of running drills to all of our running patients.

There are three main drills that significantly reduce cross-over gait: increasing cadence, running wider, and activating the hip stabilizers while moving through gait.

  1. Cadence– I talk extensively about cadence in our blog post here. In a nutshell, by increasing running cadence, there is less time for your feet to travel across midline.  Slow cadence allows more time for your feet to creep over midline.
  2. Run wide using a track line– Run around a track with lane lines (or white bicycle lane line). Run so the line is in the middle of your body. The goal is to land with the inner right foot touching the right outer border of the line and vice versa for the left foot. It may feel like you are running VERY wide but with practice it will feel more normal. Practice this drill on the straight away on the track about 4-6 times. Over time you will start to run wider naturally.
  3. Walking hip hikers– The goal is to activate the gluteal muscles, and hold while taking a step. This builds the mind body connection to the hip/core muscles while moving during gait. Watch the video below for a detailed look at the walking hip hiker.

What About Increasing Core Strength?

Core and gluteal strengthening drills alone will not magically get rid of a cross-over gait; again working on correcting the gait will do that. That being said, working on the core and gluteal muscles in conjunction with gait retraining, will support proper running gait. The stronger the supporting muscles are, the more capable they are to resist fatigue during workouts and races. Some runners have no issues with their gait for runs between 3 and 10 miles. Once long runs increase to the 12, 14, 16 mile range, gait issues begin to occur. In this scenario, strengthening workouts to the core and gluteal muscles are paramount to avoid running form breakdown during longer runs. Here are a few of our favorite core and gluteal strengthening exercises:

Gluteal bridge

Lay flat on your back, knees bent, and feet flat on the floor just wider than hip width apart. Brace your abdomen to engage the core. Press through your heels to lift the pelvis upward until it is in line with the knees and shoulders. Avoid arching through the back. Add a band around the knees for more gluteal activation. Sets: 3 Reps: 10-20

Bridges improve core and gluteal muscle strength, important for running               Bridges improve core and gluteal muscle strength, important for running

Monster walking 

Place a medium resistance mini-loop band around the ankles. Spread feet shoulder width apart and sit into a shallow squat, keeping your core engaged. Step forward and slightly outward with one foot and then repeat with the other. Take 5-10 steps forward and 5-10 steps backward. Continue until you feel a good exercises burn in the muscles of the outer hip. Sets: 3 Reps: Go until it burns

Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability               Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability

Crab walking     

Place a medium resistance mini-loop band around the ankles. Spread feet shoulder width apart and sit into a shallow squat, keeping your core engaged. Take a step to the side, then take the same distance step with the other foot in the same direction; important to not over step inward with the follow up step as this looses tension in the band. Take 5-10 steps one direction and 5-10 steps back in the other direction. Continue until you feel a good exercises burn in the muscles of the outer hip. Sets: 3 Reps: Go until it burns

Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability               Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability

Dead bug

Lay on your back, with your knees and hips bent to 90 degrees and arms held straight in front of shoulder. Brace your core by squeezing back and abdominal muscles. Slowly lower one leg towards the ground, resisting the back from arching up off the ground. Alternate legs keeping a slow pace the entire time. If this version of the dead bug is too difficult, keep the knee bent when moving the leg and perform heel taps. Sets: 3 Reps: 10 per leg

Dead bug improves lumbo-pelvic muscle control important for running               Dead bug improves lumbo-pelvic muscle control important for running

Side plank

Begin by laying on your side with the elbow tucked underneath the shoulder and feel sacked. Keep the body as straight as possible and lift the pelvis off the ground. Focus on contracting the muscles on the side closest to the floor. Perform the side plank on both sides. Sets: 3 Reps: 1 Hold: 30-60 seconds

Side plank improves lateral core stability which is important for running

Self Myofascial Release to the Gluteal muscles

Take a look at the video below. By using a lacrosse/massage ball into the muscles, muscle tension will decrease which can help with soreness, pain, tightness in the area.

These strategies help with correcting a cross-over gait. If you are experiencing shin, knee, hip, back, or foot pain from running, I highly recommend getting the injury evaluated. A targeted approach to your specific injury can prevent time lost to injury. At our Mission Valley office, we perform Active Release Technique, Graston technique, and rehabilitative exercise to keep our endurance athletes competing pain free!

Do you Run with a Cross-Over Gait?

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Do you Run with a Cross-Over Gait?

A cross-over gait, also known as a “tightrope” gait, involves running with your feet crossing the midline of your body. As each foot crosses midline, it appears as if you a running along a tightrope. This running style decreases running efficiency and may set you up for future injury (or prolong your current injury!). The areas commonly injured are the inner shin/tendons, knee, outer hip/IT band, and lower back. Beginner runners, and runners with weak core/gluteal muscles tend to run with this type of gait. 

Do you run with a cross-over gait?

The absolute easiest way to diagnose a cross-over gait is by having a gait analysis performed. A professional gait analysis is recommended but a quick video recorded by a friend can be show if the feet cross midline. Setting up a camera behind a treadmill while running solo is another easy way check for cross-over gait (see runner below).  As you watch the stride, look for where the foot lands in relation to the body’s midline.

Other signs of a cross-over gait include: excessive wear on the outside bottom of shoes, scuff marks on the inner legs ( you actually hit yourself with your foot from running too narrow!), side to side head bob noticed visually when looking straight ahead, and inline foot prints when running on sand or dirt. The main symptom of a cross-over gait is recurring injury to the same area with running. Symptoms tend to lessen with treatment and rest but return with increased running volume, intensity, or both. 

 Why is a cross-over gait less efficient?

Simply put, you are wasting energy moving side to side; the more energy spent moving side to side, less energy spent moving forward. Cross-over gait puts a lot more demand on tissues which will cause the muscles of the core, hip, lower leg to work extra hard. The demand will create more fatigue which in turn will decrease efficiency further. 

How does a cross-over gait cause injury?

With a cross-over gait, the foot strikes at or across midline , forcing our joints to work in a non-stacked position. The lower extremity performs best with a stacked orientation to absorb shock/strain with muscles. With the joints working at a slight angle, several tissues now have to work harder to absorb shock and slow down joint movement. The following injuries are commonly associated with a cross over gait:

  1. Posterior shin splints/Posterior Tibialis tendinopathy– While running with a cross-over gait, the foot lands excessively on the outside part of the foot and as the body weight shifts forward, the foot quickly flattens. The slapping down of the foot is often viewed as “over pronation” when in reality, the foot and ankle are pronating too quickly. The posterior tibialis muscle (and other lower leg muscles) must contract powerfully to slow this motion down. This causes excessive strain of the muscle causing shin and tendon pain. Over pronation is not the issue and is a reason why changing footwear in these cases is not helpful. 
  2. Knee pain– As the leg moves toward middle, the inner knee structures get over stretched. The kneecap likes to move in a straight line over the knee. If the muscles are contracting around an angled joint, abnormal tracking of the knee cap occurs.  Patients often have pain at the front part of their knee. If chronic irritation occurs, it can cause swelling around the knee/knee cap.
  3. Outer hip/IT band pain– Again as the leg moves inward, the outer hip elongates, allowing the pelvis to “drop”. This over stretches the outer gluteal muscles. As the hip muscles become more strained, the less stability they are able to provide. Trochanteric bursitis, iliotibial band syndrome are two common conditions that arise from overused/weakened hip muscles. 
  4. Lower back pain– Keeping in mind with what occurs at the hip, the low back joints and muscles get stretched abnormally as the pelvis “drops” due to weak gluteal muscle stabilization. Local low back pain is common from this constant side to side joint irritation. Symptoms may be significantly worse if a runner  has disc degeneration and/or low back joint degeneration.
Cross-over gait injuries

Potential sites for injury with cross over gait

A runner with a cross over gait and a cadence of 180 steps per minute, will cross over 5,400 times during a 30 minute run! Running with a cross-over gait will only worsen as fatigue sets in, setting runners up for injury. It is important to identify this running pattern and address the deficiencies to avoid injury. If you have chronic injuries or recurrent injuries to the same body part, you may be running with a cross-over gait. In our upcoming blog posts, we will be discussing ways to fix a cross over gait and run more efficiently.  

If you are interested in being evaluated for running injuries, our office is conveniently located in Mission Valley, San Diego!