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!

Running analysis San Diego

Running Analysis San Diego

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Running Analysis San Diego

Case Study 1- Runner’s Knee

In this running analysis case study, we look at what is exacerbating our patient’s “runner’s knee”. He is a triathlete, who is new to the sport. The knee pain is worse following runs and hard efforts on the bike. Stretching, foam rolling, Active Release treatments seem to help but the pain always returns. He has never had a running analysis, so we put him on the treadmill to see what his running technique looks like.  Watch the complete in depth running analysis below.

Additional Information

Before the running analysis, we performed a physical exam. Our patient is 6’3″ and weighs around 190 lbs. As mentioned in the video, he was found to have a slow cadence, over stride, and demonstrated a cross over gait. Those findings with a runner of his size can create a lot of impact force with each step. To reduce the strain in the knee, it is crucial to get his feet to land closer to his body. In his case, increasing cadence helped accomplish this. It is important to note however that not everybody will need to perform the same corrections to get the foot closer to the body.  This  is what makes a running analysis so valuable; each runner may need to work on different cues to accomplish the same goal.

Future Considerations

Watching the running analysis above, you may think “But he can work on this, and this, and this to help with his form too!”. I believe he can work on more cues and drills to help with his running form. BUT if you give a runner too many cues to work on immediately, they will likely get overwhelmed with the information and not properly execute the cues/drills. Further more, they will likely end up running very stiff, and out of sync making the runs feel terrible!

For these reasons, we will only give 1 to 2 cues/drills to work on at a time. We want our runners to ENJOY running while making beneficial changes to their running technique! So for our patients case, we recommend 4-8 weeks to start working on changing his technique. Then we perform a second running analysis to get a new baseline and then make further recommendations from there.

Schedule your running analysis today at www.peakformhealthcenter.com! Our running experts at Peak Form Health Center in Mission Valley, San Diego have worked with hundreds of runners. We are located near Hillcrest, Normal Heights, La Mesa, Ocean Beach, Point Loma, and Clairemont Mesa. Our exertise will get you back to running injury free and increase your performance!

Gait Analysis San Diego

Gait Analysis San Diego- Cross Over Gait

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Gait Analysis San Diego- Cross Over Gait

A running gait analysis is very helpful when a runner is dealing with an injury. One of the more problematic gaits that we identify during our running gait analysis is a cross over gait. The cross over gait or tight rope gait is present when a runner steps across the position of the previous foot of the opposite leg. They run very narrow in a cross over gait and often appear very wobbly in their legs when running. Take a look at the picture of one of our triathletes below. He has been dealing with knee pain following runs and it was found he runs with a cross over gait.

Running Gait Analysis Cross Over Gait

Signs and Symptoms of a Cross Over Gait

Often times, runners are unaware that they run with this style of gait. The most common signs and symptoms of a cross over gait include:

How to Identify a Cross Over Gait

To properly identify a cross over gait, a run gait analysis is a necessity. A run gait analysis will take a look at the runners run gait from several different views to see what form inefficiencies they are running with. Once the gait pattern is identified, gait cues/corrections are given. With dedication to drills and training, running gait changes will occur.

Can Shoes or Exercises Correct a Cross Over Gait?

Short answer is no.  It does not matter what shoes are worn if you run with a cross over gait. You may notice some improvement with certain types of shoes but it will simply mask the underlying problem and prevent the real cure. Strengthening and stretching may also help manage symptoms of the cross over gait but will not fix the cause of the injury. Strengthening may allow the runner to run further each week but eventually, the tissues will max out and fall back into injury if the cross over gait is present. The only thing that helps get rid of a cross over gait is working on changing running form.

Treatment

Schedule a running gait analysis to get proper identification of what running form inefficiencies are causing your injury. Once they are identified, running cues and drills will be give to stat making permanent changes to your running form. Our running gait analysis is performed at our Mission Valley San Diego office. We are located near the neighborhoods of Pacific Beach, Ocean Beach, Normal Heights, Hillcrest, Serra Mesa, La Mesa, and Tierrasanta. Schedule online at www.peakformhealthcenter.com to get your running form evaluated today!

 

San Diego Running Gait Analysis

Running Gait Analysis San Diego

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Running Gait Analysis San Diego

A running gait analysis helps identify common running form inefficiencies that may result in injury or at the very least decrease running performance. Our running gait analysis program in San Diego California takes a runner through multiple trials of treadmill running with video feedback. Based on the video analysis and other measurements during the running gait analysis, we can make recommendations for the runner to begin working on. We then do more rounds of video analysis to note the changes that occur with those initial running modifications. This step by step approach gives runners significant feedback to begin working on improving their running gait! Check out our brief video below to see our running gait analysis in action!

Running Gait Analysis Goals

With every runner, we have several goals in mind when performing the gait analysis. We aim to:

  • Identify major running form inefficiencies
  • Give patients running cues to start changing their running form
  • Show patients before and after videos so they can visualize the changes
  • Recommend drills and workouts to begin reinforcing those changes

With dedication from the runner, the running form changes will take permanent effect. These changes do not happen over night! Consistently performing the drills and running workouts will slowly make the changes over time. We recommend 6-8 weeks, working on the recommended changes before we do a follow up running gait analysis. This allows enough time to see how they effects have taken place.

A running gait analysis is the only tool that can identify and CORRECT running related inefficiencies. A common misconception is that if a runner works on strength training for certain muscle groups, they will improve their technique. While there are benefits to performing strength training, working on the recommended corrections DURING running is the only intervention that will improve running gait.

Our team of sports chiropractors are trained in using running gait analysis to help prevent and return from running related injury. We are certified by The Running Clinic as experts in running related injuries. Schedule today at www.peakformhealthcenter.com and come see us at our running clinic in Mission Valley, San Diego.

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Drs. Kevin and Travis Rose are chiropractors trained in managing sport related injuries. Both are avid runners and triathletes, having competed in numerous races from 5ks to the Ironman World Championships in Kona Hawaii.

 

Graston Technique Shin Splints

Shin Splints Treatment with Graston Technique

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Graston Technique is an Effective Way to Alleviate Shin Splint Pain

Shin splints is a frustrating condition that affects many active individuals especially runners and those who are in the military. Usually shin splints are a product of doing “too much, too soon” and causes pain along the tibia of the lower leg. Shin splints tend to gradually appear and gradually worsen with continued activity. Since most cases of shin splints are a chronic condition, there is development of scar tissue along the muscular attachments of the shin bone.

What is Graston Technique?

Graston Technique is a type of instrument assisted soft tissue mobilization treatment that uses specific tools to mobilize the tissues of the body. Graston Technique mainly functions through two mechanisms: 1. mechanical break down of tight tissue, and 2. increase blood supply to the injured area.

In areas of significant fibrosis, patients will feel a lot of vibration from the scraping of the Graston tool. With continued work through the tight areas with the Graston tools, blood flow significantly increases and patients report the area “feels warm” and looks fairly red. The blood flow brings in fresh oxygen, nutrients, and other pro-inflammation molecules to generate a more significant healing process. After the treatment, soreness is expected but often feels better 12-24 hours post treatment. Watch the following video to see how the Graston Technique is used for treating shin splints.

Why Do Shin Splints Come Back?

In some cases, shin splints return even after feeling better with Graston treatment. When this occurs we need to think more outside of the box to figure out why shin splints are persisting. Most commonly they return due to: patient performs “too much, too soon” with their activity, there are technique flaws with their sport, and/or they need to become stronger to support their body.

Using running as an example, if a runner tries to immediately go back to pre injury mileage, they are risking reinjury; they need to gradually get back to pre inury mileage. Common running technique flaws are running with a cross-over gait or running with a slow cadence. Read Do you Run with a Cross-Over Gait? Cross-Over Gait Correction Increase your Cadence! for more information on running flaws that cause injury.

Schedule with our Sports Chiropractors today. We are trained in Graston Technique, Active Release Technique, and rehabilitative exercise to fix your shin splints quickly and efficiently. We also use Running Gait Analysis for stubborn shin splint cases. Dr. Rose is certified by The Running Clinic to treat and manage running related injuries. Our office is conveniently located in Mission Valley, San Diego near Pacific Beach, Ocean Beach, Normal Heights, Hillcrest, Serra Mesa, Clairemont Mesa, La Mesa, and Kensington. Schedule online at www.peakformhealthcenter.com or give us a call at 619-818-4306 today!

Active Release Technique San Diego

Manage Triathlon Injuries and Training

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Triathlon season is in full swing here in San Diego. With local races nearly every weekend, many triathletes have trouble balancing time between training, family, jobs, and racing competitively. Many triathletes begin to notice nagging triathlon injuries that are consistently getting worse as the season continues. Should they take a break to heal? Maybe. It depends on the athlete, their goals, and how they take care of their bodies during the season. Below are the top 5 triathlon injury management techniques we recommend to our athletes.

Active Release Technique ART San Deigo

  • Sports Chiropractic Care– We may be slightly biased here but this is the reason why we do what we do. We offer the best manual therapy and exercise methods to keep our triathletes swimming, biking and running. Triathlon injuries are managed effectively with a combination of Active Release Technique, Graston technique, joint manipulation and rehabilitative exercise. Have you seen or are you currently seeing a Sports Chiropractor? Sports chiropractic utilizes all the techniques previously mentioned as well advice on training through the injury; you can read more about the difference between a general chiropractor and a sports chiropractor here: Benefits of Sports Chiropractic.DACBSP Certfified
  • Maintain a Self Care Program– After being screened by a Sports Chiropractor and prescribed exercises, it is important that you do them! A daily routine of foam rolling, stretching, strengthening to the areas that have been causing injury. Daily is best but if you can squeeze in 3 times per week to manage triathlon injuries, you will see positive results.IT band syndrome San Diego, Gait San Diego
  • Sleep– It is important when training to stick to an appropriate sleep schedule. Getting quality sleep allows your body to regenerate after you break it down during hard training. In a nutshell, deep sleep allows growth hormone and other rebuilding hormones to be released which will allow you to bounce back faster. If sleep is constantly sacrificed for more work, or more training, the body will become catabolic and slowly break down. When trying to manage triathlon injuries, if you do not allow the body to rebuild, the injuries will never fully heal.
  • Nutrition-  Proper nutrition gives the building blocks to your body to allow for proper recovery.  The more high quality fuel you give yourself, the high quality output and recovery you will get. Just like a sports car, you will not put regular unleaded gas in tank, you will put premium gas in to get the most out of the high performance engine. In general, high quality carbohydrate (lots of veggies, whole grains), lean proteins, and plenty of healthy fats are what you want to strive for! After exercise sessions, especially high intensity interval sessions, drink a mixture of carbohydrate and protein to refuel the glycogen stores in the muscles. 
  • Periodization- We see countless athletes in our office who suffer from over training syndrome. A lot of it stems from the fear of not doing enough to get ready for a race or losing too much fitness between exercise sessions. With a proper training plan in place, you will become fitter, faster, and having to manage triathlon injuries will become a thing of the past. In short, get an experienced coach, or at the very least get a training book and follow it.

Those are the top 5 tips to help manage triathlon injuries and avoid new injuries moving forward. We recommend getting a physical assessment by one of our sports chiropractors located in Mission Valley, San Diego. We are located near the neighborhoods of Hillcrest, Serra Mesa, Clairemont Mesa, La Mesa, Pacific Beach, Ocean Beach, and Point Loma. Our Sports Chiropractors are trained in musculoskeletal diagnosis and treatment, running gait analysis, bike fitting, and can order the proper diagnostic tests if necessary (MRI, X-ray, etc.).

 

Dr. Travis Rose, DC CCSP and Dr. Kevin Rose DC DACBSP are both avid triathletes and are passionate about helping triathletes manage triathlon injuries. Knowing first hand how frustrating a nagging injury can be, both Dr. Travis and Kevin utilize Active Release Treatments and chiropractic treatments to keep them healthy and performing at their best!

San Diego Marathon Running

Get Ready for the San Diego Rock ‘n’ Roll Marathon

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The San Diego Rock ‘n’ Roll marathon is coming up! You are likely finishing your build phases of training and are headed into a much needed taper to help rebuild your body before the big day. Now that training volume has decreased, you have more time to address your body to get it into tip top shape before race day. Beyond foam rolling, stretching, and mobility work, the following are services that can help decrease tightness, soreness, aches, and pains before your big day. Our office accepts most major insurances and offers affordable cash rates. Our San Diego Chiropractors treat runners and running injuries on a daily basis using the following techniques:

Active Release Technique– Our staff is trained in Active Release Technique which is a state of the art soft tissue injury management system. Our chiropractors utilize ART to help reduce tightness and soreness at isolated parts of the body. For example, many runners feel tight in their hips and quadriceps following long runs. One or two ART sessions before the Rock ‘n’ Roll Marathon can help rid the muscles of that tightness.

Active Release Technique Marathon Running San Diego

Graston Technique– While training for the Rock ‘n’ Roll Marathon, if any injury is long standing, particularly in a tendon, Graston is excellent to get ample blood supply to that area. Our San Diego Chiropractor will sometimes have runners perform movements while using the Graston tools to help facilitate movement between the fascia and muscles. Bascially, your muscles move better so you do not feel tight and sore before your race!

graston technique in san diego Marathon running

Spinal Manipulation– If your back is stiff and lacks proper range of motion, spinal adjustments may be the right treatment for you. Spinal manipulation is an excellent treatment to help restore proper joint mobility. Spine stiffness is a common complaint in runners especially when training for a marathon due to the long hours of training and consistent bouncing motion into the spine.

Massage Therapy– Our massage therapist is an avid runner and endurance athlete. If you have numerous areas of tightness and soreness, schedule a massage to have a nice once over to all of those complaints.

Head into your race feeling as healthy as you can and you will see great results. After the San Diego Rock ‘n’ Roll Marathon, we recommend our runners to receive treatment about once every 4 weeks to help reduce tightness in the common running muscles and joints. Our office is conveniently located in Mission Valley, San Diego near the Rock ‘n’ Roll Marathon course!

Good luck in the San Diego Rock ‘n’ Roll Marathon!

running with IT band syndrome San Diego

IT Band Syndrome: 5 Training Tips

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Trying to run with IT band syndrome is very frustrating. Often times, a runner can run with IT band syndrome for a certain amount of time until the pain comes back or becomes so unbearable that they have to limp home from their run. Our chiropractors treat runners who run with IT band syndrome as well as other running related injuries.

Top 5 training tips for IT Band Syndrome

Decrease volume– IT band syndrome is worse with a high number of repetitions. When you run with IT band syndrome, try reducing your volume by 50% to start off.

Avoid down hill running– Down hill running causes more force into the quadriceps and less activation from the glutes. The glutes play a very important role in knee stability. Without proper glute activation, a run with IT band syndrome through hills will make things worse. Stick to flat surfaces.

Increase intensity– Volume is the main issue when dealing with It band syndrome. With the decreased run volume, it is ok to get more out of those shorter workouts. Adding some intensity will help keep fitness levels high for training.

Run/Walk- This technique will help you keep the repetitions low. If you have tried to run with IT band syndrome for a long time without success, this option may be a good way to start back into running.

Uneven Surface running– Running on concrete or other flat surfaces hits the same muscles in the same direction over and over. If you run on a trail that has varying terrain (and limited ups and downs) this will cause the hip muscles to work more in different orientations. This will help build overall strength to support the hip and the knee.

These tips can help manage and allow you to run until the symptoms improve and you are pain free. These training modifications combined with manual therapy and exercise like our running chiropractors in San Diego perform, can help get you out of pain even faster. Our office is conveniently located in Mission Valley, San Diego.

Both Dr. Travis Rose, DC CCSP and Dr. Kevin Rose DC DACBSP are avid triathletes and runners. As experienced triathletes, Dr. Travis and Kevin Rose understand the frustrations of running injuries and try their absolute best to get you better, faster!

Outer hip pain running clinic San Diego

Outer Hip Pain in Runners

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Outer hip pain is a very common complaint we see with out runners at our Mission Valley office. The outer hip musculature is designed to provide hip, and lower back stabilization during running. When there is pain or tightness at the outer hip, the stability at the hip and lower back is compromised. This in turn can create abnormal stress into the hip, outer hip muscles, lower back, the knee, and even the lower leg/foot. The following conditions cause outer hip pain and dysfunction:

Causes of Outer Hip Pain

  • Glute Medius Muscle Strain
  • Tensor Fascia Latae Strain
  • Gluteus Medius Tendinopathy
  • Trochanteric Bursitis
  • Iliotibial Tract Syndrome (IT Band Syndrome)
  • Sciatic Nerve Entrapment

As mentioned above, the out hip plays a role in lower back and hip stability. If the outer hip is painful or dysfunctional the following conditions may also be present:

  • Low Back Pain
  • Facet Joint (Lower Back Joint) Irritation
  • Hip Impingement
  • Knee Tracking Issues
  • Outer Knee Pain (IT Band Syndrome)
  • Shin Splints
  • Plantar Fasciitis

Evaluation

It is important to be evaluated by a running doctor and sports chiropractor. We will help diagnose your outer hip pain and any potential compensatory injuries that may be occurring simultaneously.  A combination of range of motion, orthopedic, functional movements, and strength/endurance tests will be used to pinpoint the exact cause of your pain.

Gait Analysis

We currently offer at home gait analysis for current patients. After being evaluated in our office, if it is deemed necessary, we have our patients video tape themselves running on a treadmill and send it back to us for evaluation. For outer hip pain, many runners with outer hip pain run with what is known as a cross over gait. Check out our previous blog posts here on what a cross-over gait consists of.

Hip pain Running San Diego

Potential sites for injury with cross over gait

Treatment for Outer Hip Pain

Active Release Technique is an excellent tool for helping runners with outer hip pain get out of pain quickly. A targeted home rehab approach is then prescribed b our running doctor as a way to prevent the injury from coming back again. Schedule with us today at our Mission Valley, San Diego running injury clinic today!

The Running Clinic Certification

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Congratulations to Dr. Travis Rose, DC CCSP for successfully completing the course in “New Trends in the Prevention of Running Injuries”! This course, taught by The Running Clinic, teaches health care providers about the latest methods to treat and manage running injuries. Dr. Rose is currently the only healthcare provider with this certification in Mission Valley, San Diego.

Running Clinic Running Doctor San Diego

The following is a quick Q and A with Doctor Rose regarding running injuries.

Q: Having taken this latest course, put on by The Running Clinic, what were the main takeaways to prevent running injuries?

Dr. Rose: The main takeaways for injury prevention and increasing running efficiency were the following: 1. Run with a cadence between 170-180 steps per minute, 2. Limit the up and down motion while running (decrease vertical loading associated with injury), and 3) Use as little of a shoe as possible as this allows you to run more naturally.

Q:  Was there information that surprised you or went against conventional running information?

Dr. Rose: The biggest “eye opener” was the fact that there is zero research to support prescription of specific shoes for specific types of feet. Many people put their trust in companies to tell them which shoe to buy based on treadmill analysis. Unfortunately there is research that shows that shoes don’t limit pronation like they claim to do. So why give somebody a big bulky shoe when it doesn’t do what it is designed to do? Instead, work on the items listed above and become a better runner!

Q: What is the biggest cause of injury in runners?

Dr. Rose: It is when a runner changes something. For example, a runner runs 25 miles per week, same distances for each run. But then decides to run an extra 10 miles one week. That change in volume is what will likely cause an injury to pop up. Another example is always running on concrete or hard trails, then deciding to run 10 miles on soft sand. The body was not ready to support a long soft sand run and an injury occurs.

Q: There is a lot of information for exercises online to help improve running technique, can a runner do home exercises and fix their running flaws?

Dr. Rose: Unfortunately no. I used to be under that assumption when I was an injured runner. I would get frustrated when I would do a ton of strength exercises and core work to then run 2 miles and have that all too familiar pain come back. Running gait needs to be corrected to take strain off the injured area. Using myself as an example, I suffered from repeated shin splints due to cross over gait. It did not matter how much glute or calf strengthening I did because once I ran incorrectly again, the tendon would get overloaded and I would be back to square one. Once I learned to run with a wider step width and have a faster turn over (faster cadence), my injury went away almost immediately and I was able to slowly build back up.

Q: Any other advice on running injuries that you learned?

Dr. Rose: When in doubt, get it checked out. Running should be fun and injury free. I hear too many stories from patients about how tight and sore they are after every run. Or that pain is something “you deal with as a runner”. Not true! Get evaluated by a running doctor who can get your gait back on track. If there is not a running doctor in your area, there are a few pieces of wearable technology that can help. One being Lumo Run which gives feedback on cadence, vertical bounce, hip drop, hip rotation, and braking force. If you already run with a running watch, usually they have features that you can use (like cadence) to start really emphasizing proper technique.

Dr. Travis Rose DC CCSP and Dr. Kevin Rose DC DACBSP are Chiropractors trained to treat a wide variety of sport related injuries. Schedule a visit at our Mission Valley, San Diego office!