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

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!

Treatment for Plantar Fasciitis San Diego

Treatment for Plantar Fasciitis | San Diego

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Treatment for Plantar Fasciitis | San Diego

Plantar fasciitis is a frustrating condition that can linger for weeks, months, or even years. It is characterized by pain on the bottom of the heel and even into the arch of the foot. Usually the symptoms are worse when you take your first few steps out of bed. As you move around, symptoms lessen but do not go away. Treatment  is multifactorial, meaning several different approaches usually help fix the issue.

In our sports injury clinic in Mission Valley, San Diego we primarily use Active Release Technique, and Graston Technique treatment for plantar fasciitis. These treatments combined with treatment for plantar fasciitis at home, we see excellent outcomes.

Common Causes of Plantar Fasciitis

There are many causative factors for developing plantar fasciitis. Successful treatment of plantar fasciitis involves discovering the root cause of the injury. Here are the main factors that lead to plantar fasciitis:

  • Standing and walking on hard surfaces for long periods of time
  • Over training, especially with running
  • Excessive forceful jumping or pushing (basketball, football)
  • Ill fitting footwear or shoes without proper support
  • Excessive body weight
  • Congenital foot and lower extremity issues (flat arches, tibial torsion)

    Treatment for Plantar Fasciitis San Diego

 Conservative Treatment in San Diego

At our Mission Valley office, we have treated countless plantar fasciitis cases. Watch the video below to get a full understanding of how we treat plantar fasciitis.

After treatment we work with each and every patient to develop custom exercise programs for patients to perform at home. If a patient is diligent with their home care, patients often see great results.

Check out our blog post Top 7 Ways to Treat Plantar Fasciitis at Home. Usually we recommend a combination of those 7 recommendations to help with continued improvement.

If you have been experiencing heel pain and looking to get it resolved, please do not hesitate to schedule. Our  Sports Chiropractors are trained to properly diagnose plantar fasciitis and other conditions that may be affecting the heel. Our office is conveniently located in Mission Valley near Normal Heights, Pacific Beach, Ocean Beach, and Hillcrest.

Proper Foot Strike San Diego Run Analysis

Which Foot Strike is Best for Running?

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Midfoot Strike San Diego Running Gait AnalysisHeel Strike San Diego Running Gait AnalysisForefoot strike San Diego Run Gait analysis

Which Foot Strike is Best for Running?

There is some debate as to which foot strike is best for running. Forefoot striking has been given a lot of attention due to the book “Born to Run” and the research by Dr. Daniel Lieberman of Harvard University. Essentially, it was found that natural runners (runners who run their whole lives) run with more of a forefoot strike which was also shown to decrease force at initial foot strike. These facts led to the conclusion that forefoot striking is the best way to run and prevent injury. Many people began forcing themselves  to run forefoot, or run barefoot which helped produce a forefoot strike naturally. Many people also found themselves severely injured due to the excessive strain on the Achilles Tendon, metatarsal bones, and plantar fascia!

Drastically changing the style in which you run is a major risk factor for injury. Is it possible to run as a fore foot striker? Absolutely! But if you were a habitual heel striker and then over night performed all of your mileage as a forefoot striker, you are asking for an injury. Any time you make change to your running form, it should be done gradually over weeks and months so your body has time to adapt and become stronger with the new style.

So Which Foot Strike is Best for Running?!?

There are three types of foot strikes with many variations between the three. Here is the answer, any and all foot strikes can be best for running! There are other more important aspects of running that must be dialed in and in most cases, how your foot strikes the ground is not a huge concern.  Where the foot lands in relation to your body is a more important area to address. If the foot is landing far away from your body, when the foot lands, a “braking” force will press back against your body, making you less efficient. This will ultimately cause fatigue, muscle soreness, and potentially lead to injury.

Running mechanics San Diego

Runner allowing foot to travel too far forward. Will land with “braking” force against body.

If you work on landing your foot closer to your body, you maintain forward momentum much more easily, thus making you a more efficient runner! It is also less jarring to your muscles and joints so it can prevent injury. So how does one land closer to the body? Many times runners need to work on taking smaller steps and usually the easiest way to do this is to increase cadence. Normal cadence is a range from 170-190 steps per minute (regardless of how fast you are running). By upping the cadence, you are forced to take smaller steps resulting in a foot strike closer to the body.

Adjusting to a faster cadence takes time. Read our article here to learn about ways to practice increasing your cadence. Some runners say, “It doesn’t feel natural to run with a faster cadence.” or “I just don’t feel like it works for me.”. Increasing cadence does not have to be a permanent fixture to your running form! However, performing higher cadence drills will retrain your body to take those smaller steps. So after weeks and months of practice, you will naturally get the feel for where the foot should land which is closer to your body. Then you can essentially run at whatever cadence feels comfortable now that the smaller steps are built into your muscle memory.

Foot Strike San Diego Run Technique

Landing with foot close to body, maintaining forward momentum.

One More Time… Which Foot Strike is Best for Running?!?!?!?!

Ok, I will pick a side, sort of. First, work on the above mentioned techniques to improve where your foot lands. Now, in general, an excessive heel strike, or an excessive forefoot strike can lead to injury. So trying to land more mid foot or a slight heel strike or a slight forefoot strike will likely make you a more efficient, healthier runner. What is an excessive heel strike or an excessive forefoot strike? There is not an exact measurement or anything along those lines. But if a runner demonstrates either type of foot strike during our running gait analysis and it is corroborated with the symptoms they are presenting with or and injury they have, then we determine it is excessive and try to reduce that type of excessive strike (forefoot or heel).

Other Helpful Information on Foot Strike

Check the wear pattern on your shoes. If you notice your heel is significantly worn compared to the rest of the sole of your shoe, then you are likely excessively heel striking. On the bottom of the shoe, look at the sides. Is there more wear on the outer part of the sole, more on the inner? That can signify excessive tilting of the foot when your foot hits the ground. This can also cause issues with your gait and result in injury.

Conclusion

I hope this article was helpful at explaining that there isn’t a foot strike that is best for running. If you are suffering from running related injury, or have recurring symptoms, schedule an appointment with chiropractors today. We treat all types of running related injuries. We will perform a thorough history and evaluation and begin treatment right away (unless further imaging is required). Our running gait analysis program is another tool that we use. It helps identify common biomechanical inefficiencies that lead to poor running form and increase chance of injury. Check out one of our run gait analysis videos here. Our chiropractic office is conveniently located in Mission Valley, San Diego. We are near the neighborhoods of Serra Mesa, La Jolla, Sorrento Valley, UTC, Mira Mesa, Clairemont Mesa, Poway, and Scripps Ranch!

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Dr. Travis and Kevin Rose are avid runners and triathletes. Dr. Rose is a certified running healthcare provider through The Running Clinic, the premier source for running injury information.

 

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!

Low Back Pain Exercise San Diego

Exercise to Combat Low back Pain in San Diego

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Low back pain is a painful, frustrating, and sometimes disabling condition. There are many different causes of low back pain (Different Types of Low Back Pain) but there are similar characteristics among back pain conditions that can be addressed to help address it. Common risk factors that are associated with low back pain are: Tall stature, obesity, weak core musculature, muscle imbalances, prior back injury, family members with low back pain, improper lifting or exercises mechanics. In our chiropractic office in Mission Valley, San Diego, near Pacific Beach, Ocean Beach, Hillcrest, and North Park, we see many types of low back pain. Majority of the time we need to address the functionality of the core. Many patients who are experiencing low back pain often carry their low backs in a disengaged position which causes hyperextension and irritation of the joints of the low back. This hyperextended position is often due to inhibition (inability to control) of the core musculature. By addressing this inhibition, patients begin to learn proper “lumbopelvic” control and posture, meaning they are able to hold their back in a stable position during their daily activities. The following low back exercise for low back pain, called the dead bug, is an excellent drill to utilize to teach patients how to use their deeper core musculature which is important in getting patients out of low back pain. The more control that is developed in these muscles, the more stable the back will be and less prone to causing pain.

“Dead Bug” Core Exercise

Start by laying on the ground with the legs bent 90 degrees at the knee and above the hip. Now, there should be an arch in the lower back or in other words, some space between the ground and the low back. Press the low back in towards the ground; this engages the deep abdominal and spinal core muscles. If you have pain when pressing down, try rolling up a towel about 1″ thick and place that under the low back for support. Hold the core engaged and slowly straighten one leg toward the ground about 6″ from the ground and back; repeat on the other leg. It is important to keep the back pressed toward the ground to develop the lower abdominal strength. Repeat this exercise, 3 x 10 nice and slow! If you can’t make it to 10 before you fatigue and the back arches, then stop on whatever rep it is that you maintain proper back position. Check out the video below for more details for the “dead bug” exercise.


If you are having low back pain, please get a full evaluation before attempting any new exercise routine. Back pain is complex and not all exercises work for every type of low back pain. Get a proper diagnosis with one of our sports chiropractors today. We are conveniently located in Mission Valley, San Diego. We are near the neighborhoods of La Jolla, UTC, Poway, Scripps Ranch, and Normal Heights. We are experienced in treating all types of low back pain!

Tennis Elbow Treatment San Diego

Tennis Elbow Treatment with Flexbar

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Tennis Elbow Eccentric Exercises

Tennis elbow or lateral epicondylitis is characterized by pain and possible swelling on the outer part of the elbow. It is caused by overuse of the extensor muscles of the forearm which chronically strains and pulls into the bone (epicondyle) of the outer elbow. As the name suggests, tennis players will get this condition due to the amount of force and tension that the forearms absorb when hitting a tennis ball. We also see tennis elbow in people who perform a lot of typing/computer work; the constant lifting of the fingers cause overuse of the extensor muscle group and results in tennis elbow.

In Office Tennis Elbow Treatment

Treatment in our San Diego office consists of Active Release Technique, Graston Technique, to break down the tight musculature pulling into the tendon and bone. Recommended home care consists of self myofascial release (see Armaid) and Theraband Flexbar. For successful treatment, it is important for both the chiropractor and patient perform their parts of the treatment. The video below describes the Theraband Flexbar protocol. In a nutshell, the Flexbar exercises should be performed daily, 3 x 15 with a 2-3 second eccentric contraction; when 3 x 15 becomes easy, move up to the next level resistance Flexbar.

When performing these exercises, expect to feel some discomfort in the area; it targets the injured area so this can be completely normal. At home tennis elbow treatment should not worsen the pain, and should start to feel improvement with exercise consistency. As always, please get the elbow evaluated. It is important to get a proper working diagnosis from a Sports Chiropractor familiar with overuse injuries. Our office is conveniently located in Mission Valley, San Diego. We treat tennis elbow near the neighborhoods of Serra Mesa, La Jolla, UTC, Linda Vista, Poway, and Scripps Ranch.

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Dr. Travis Rose, DC CCSP and Dr. Kevin Rose, DC DABCSP are Sports Chiropractors who treat sports injuries in San Diego, California. Not only do they treat athletes regularly, they are athletes themselves, participating in triathlons, running events, and recreational team sports.

San Diego Chiropractic Hip Flexor Stretch

How to Perform an Effective Hip Flexor Stretch

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A Safe and Effective Hip Flexor Stretch

The main muscles that make up the “hip flexors” are the rectus femoris, iliacus, and psoas major. This muscle group can become overactive and tight resulting in a variety of musculoskeletal issues. Many people perform a hip flexor stretch as a routine, or to help with a specific condition: knee pain, hip pain, back pain. Unfortunately, we see many patients who are performing a hip flexor stretch incorrectly and are exacerbating their condition. Take back pain as an example. Tight hip flexors can cause abnormal posture through the low back resulting in joint compression and irritation. Many patients will then stretch the hip flexors aggressively to help alleviate the symptoms. However, in an effort to loosen up the hip flexors, patients are compromising their low back by compressing a twisting the joints. To stretch the hip flexors properly, there are a few cues that you want to pay close attention to. Take a look at the following video; we go through the proper set up and execution of a safe hip flexor stretch.

Now, if you search “Best hip flexor stretch” you will get thousands of results and some are going to look really cool, and effective. At our chiropractic office in Mission Valley, San Diego we strive for keeping the exercises simple, accessible, and effective. Many of the “cool” or “aggressive” hip flexor stretches often put patients into compromised positions for their condition. Try this version of the hip flexor stretch. If you are suffering from low back, knee, or hip pain, please schedule with us to get a full evaluation. We specialize in treating sports injuries and tight hip flexors are a common presentation we see in our athletes as well as our workforce patients. Our office, Peak Form Health Center, is conveniently located off Texas Street, in Mission Valley, San Diego.