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!

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!

IT Band Syndrome treatment San Diego

New Methods in Treating IT Band Syndrome

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IT  band syndrome remains a stubborn condition that our chiropractors treat at our office in Mission Valley, San Diego. Runners, triathletes, and cyclists are the main groups of people who we treat for this condition. We previously posted treatment recommendations for IT band syndrome (found Iliotibial Band Syndrome) but wanted to update the information regarding treatment. The previous post still highlights relevant treatment advice in terms of research based treatment. Continue below to see the most recent types of treatment our San Diego chiropractors utilizes to best treat IT band syndrome.

Do you truly have IT band syndrome?

Many patients self diagnose their knee pain as IT band syndrome. They may be correct but true IT band syndrome is characterized by outside (lateral) knee pain right at the bony attachment of the IT band. It is often worse with repetitive movements such as running, walking, hiking, and cycling.

There are many cases that we have seen where the patient is experiencing general knee pain and were diagnosed with IT band syndrome. After our chiropractor evaluates the knee pain, it is often found that the person is experiencing knee pain due to muscle imbalances between the front of the thigh and back of the thigh. The pain and discomfort is often due to very tight and sore quadricep muscles. IT band syndrome is diagnosed because the IT band itself is found superficial to the outside quadricep muscle.

These patients are categorized as “quad dominant” and our San Diego Chiropractor works on the tight/sore quadricep muscles while strengthening the back thigh muscles, namely the gluteus maximus and hamstrings. Along with general strengthening and stretching, the patient must be taught how to use the glute muscles and hamstrings more during their activity.

New Treatment Approaches

We have had a lot of success using various types of myofascial release. Our San Diego Chiropractors have been trained in Active Release Technique and Graston Technique. Cupping is another therapy that has been used to help increase mobility between muscle fibers. Using motion with different types of myofascial techniques is especially helpful for treating IT band syndrome in runners, cyclists, and triathletes. The movement with myofascial work helps create mobility between layers of muscle/fascial tissue that often gets “bound up” with the constant repetitive stress from the sports mentioned previously. Take a look at the videos demonstrating IT band syndrome treatment:

Cupping used during athletic movements to decrease tissue compression and increase blood flow

Active Release Techique applied to the quadricep and IT Band

Strengthening the Hips for IT Band Syndrome

The previous article (found Here Iliotibial Band Syndrome) we wrote discussed several exercises that are still beneficial for IT band syndrome. We are finding even more success with more aggressive glute and hamstring exercises to help stabilize the hip and knee. Below is one of our favorite hip extension exercises. You can perform it one side at a time to make sure you are getting the most out of each hip. Our San Diego chiropractor treats many running injuries and will also assess different muscles groups to help establish proper running form. 

If you are experiencing IT band syndrome, it is important to get evaluated by a sports chiropractor. Our San Diego Chiropractors work with all types of athletes. Each treatment is unique to the individual but likely includes some form of myofascial release, stretching, and strength training. Our office is conveniently located in Mission Valley, San Diego.

Big toe pain treatment San Diego

Functional Hallux Limitus

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Proper motion through the big toe is important for walking and running. When running, as the leg moves backwards, the hip, knee, ankle (dorsiflexion), and big toe extend to propel the body forward. Loss of range of motion at one or multiple of these areas will decrease efficiency and can lead to potential injury. Functional hallux limitus is a condition that limits the amount of big toe extension. When running with this condition, a runner will avoid pushing off the big toe or will not extend fully through the hip due to the poor range of motion at the big toe. Both cases lead to poor biomechanics and potential injury.

Identifying Functional Hallux Limitus

Many times patients report that they had imaging from their previous provider and we told their big toe joint is “normal”. Generally what that means is that there are no fracture and there is no arthritis but no diagnosis is made. Functional hallux limitus means that the big toe has limited extension during gait. In other words when that joint tries to function, range of motion is limited. If you do a test non-weight bearing, the toe will have great range of motion. So is a provider is not familiar with this condition, they will say everything seems normal, stop running until it calms down.

Let’s do a quick test to see if you may be dealing with functional hallux limitus. Sit down and cross one leg ,over the top of the other leg’s thigh. Now reach down and pull back the big toe. It should move back very easily (unless you have hallux rigidus). Now, repeat the process but this time, press your thumb firmly into the bottom of the big toe joint and hold. Try and pull the big toe back. If there is very little motion, you may be dealing with functional hallux limitus. The force from your hand pressing up into the joint mimics weight bearing. So if you have poor extension with just your hand, with full body weight through the joint, motion will be more poor.

functional hallux limitus running doctor

 

 

 

 

 

 

 

 

 

 

Evaluation

Assessing the big toe is relatively straight forward. The test found above is a “go to” test for our sports chiropractors and running doctors. Overall foot  and ankle range of motion will be assessed. Structural limitations will be evaluated as well, such as presence of:

  • Plantarflexed first ray
  • Forefoot valgus
  • Forefoot varus
  • Rearfoot valgus
  • Rearfoot varus
  • Pes Planus
  • Pes Cavus
  • Bunions

Treatment

Some cases respond well to aggressive soft tissue work to the restricted tissues. Active Release Technique and Graston technique with exercises can help breakdown tight tissues that may be causing functional hallux limitus. Other cases will need shoe insert modifications to allow for the proper range of motion at the big toe. General recommendations can’t be made as it is strictly a case by case basis; some patients need one modification while others need a different one.

Our running doctors and sports chiropractors will thoroughly evaluate your specific complaint. We are conveniently located in Mission Valley, San Diego!

Big toe pain treatment San Diego

Big Toe Pain and Conservative Treatment

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Many sports and activities of daily living require movement through the foot and big toe. When you are experiencing big toe pain, sports and certain activities can become quite difficult to perform. If your big toe pain is extreme, simple tasks such as standing, or walking can become very difficult. You may have heard of professional athletes missing months from their sport due to “turf toe” or other big toe conditions. The first thought (and I used to be guilty of this!) is, “It’s only your toe! Get out there and play!”. Well, if you are a 300 pound lineman in football and yue pressing through your big toe to try and stop an equally sized person, then there is tremendous load though a very small joint! When thinking of it from that perspective, it’s amazing that more athletes do not succumb to big toe pain and dysfunction.

Causes of Big Toe Pain

Acute Causes

Most commonly, a big toe joint can become sprained when it is bent backward or forward forcefully. This over stretches the joint and tendons in of the big toe. The following two acute conditions are commonly seen in our sports injury clinic:
Turf toe-Using a football lineman as an example again, when he is pressing forward and is met with equal or greater force by the opposing lineman, the big toe can get over stretched. Pain is generally felt on the bottom of the big toe and is difficult to walk due to the inability to push off.
Sand toe- A soccer player is playing barefoot on the beach and goes to kick the ball. She misreads the position of the ball on the sand and kicks the sand more than the ball. This forces the big toe joint downward, overstretching the top of the
joint and attached tendons.

Chronic Causes

We more commonly treat big toe pain due to chronic reasons. These conditions generally develop over time and are seen in middle aged and older patients (although these can affect younger populations in some cases). The following are common big toe conditions we treat:

  • Hallux valgus
  • Bunion deformity
  • Sesamoiditis
  • Functional hallux limitus
  • Hallux rigidus

Structural issues

In many cases, especially associated with chronic conditions, foot structure may cause pain and dysfunction at the big toe. Most commonly, we see the following:

  • Forefoot valgus
  • Forefoot varus
  • Plantarflexed first ray
  • Subtle cavus foot
  • Pes planus
  • Pes cavus

Inflammatory conditions

Some patients deal with recurring inflammation of the big toe joint. There are a few inflammatory arthritides that can affect the big toe. The most common cause of big toe joint pain and inflammation is Gout. A referral to a rheumatologist is warranted if an inflammatory arthritis is suspected.

Evaluation

Our Sports Doctor of Chiropractic will evaluate the big toe, foot, ankle, lower leg, and possibly continue up the body into the lower back. Some conditions can be affected by muscle/joint dysfunction above where the pain is actually occuring.

Treatment

When it comes to big toe pain, Active Release Technique and Graston technique can help restore normal tissue function around the big toe. Chiropractic adjustments to the ankle, and midfoot can help with proper foot function to de-load the painful big toe joint. Exercises are also prescribed to strengthen/stretch the small muscles of the foot to improve big toe mobility. If there are structural issues present and a patient has recurring symptoms or does not improve with care, orthotics may be prescribed to accommodate the structural issue.

Knee pain san diego treatment

Patellar Tendonitis and Knee Pain

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The patellar tendon runs from the bottom point of the patella (knee cap) and runs down to the top of the tibia (shin bone). It acts as a pulley to lift the leg upward into extension when the quadricep muscles contract. Leg extension is important in many sports and day to day activities; squatting, walking up and down stairs, getting in and out of cars, etc.
When the quadriceps become overused, excessive amount of load occurs at the patellar tendon and patellar tendonitis begins to develop.

What are the Symptoms of Patellar Tendonitis?

Patellar tendonitis is characterized by pain and possibly inflammation along the patellar tendon. Early stages of patellar tendinitis tends to cause pain after exercise/aggravating activity, and then goes away hours after the activity; it may also be felt at the start exercise but feels better as exercise continues. As the condition progresses, pain may be felt before, during, and then is worse after exercise. If it gets ignored and an athlete tries to push through the pain, the tendon will actually start to deteriorate resulting in patellar tendinosis.

Patellar Tendonitis Treatment San Diego

Who are at risk?

Athletes who perform repetitive jumping and leg bending are at risk to develop patellar tendonitis. Basketball players, CrossFit athletes, volleyball players, runners, cyclists, backpackers/hikers, triathletes, are all at a higher risk due to the potential overuse of the quadricep muscles. Specifically for running and hiking, performing lots of down hill routes will increase the likelihood of developing patellar tendonitis.

Evaluation

In most cases, patellar tendinitis can be diagnosed with a thorough history of the injury and brief physical exam. In some cases, imaging such as a X-ray or MRI may be necessary to rule out other conditions such as meniscus injury, patella alta, chondromalacia, arthritis, etc. Check out our blog here for other causes of anterior knee pain.

Treatment for Patellar Tendonitis in San Diego

For acute pain relief, Active Release Technique, Graston Technique, stretching, foam rolling, and training modification are essential. As the patient improves, eccentric exercises are prescribed to repair the patellar tendon. This helps strengthen tendon fibers to resist future load from activity. Eccentric loading for patellar tendinosis is even more important as this restarts the inflammatory process at the tendon so the tendon can heal.

Stop dealing with patellar tendinitis on your own. Schedule today to get evaluated by our sports chiropractors located in Mission Valley, San Diego. We have helped countless athletes overcome knee pain with our targeted approach.