Posts

Active Release Technique San Diego

Manage Triathlon Injuries and Training

/in , , /by

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!

running with IT band syndrome San Diego

IT Band Syndrome: 5 Training Tips

/in , , /by

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

/in , , /by

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

Big Toe Pain and Conservative Treatment

/in , /by

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.

Outer hip pain running clinic San Diego

Outer Hip Pain in Runners

/in , , , /by

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!

Hip pain running doctor San Diego

Types of Hip Pain and Running

/in , , /by

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

/in , , /by

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

/in , , /by

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!

Walking Hip Hike for Running

/in , /by

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

/in /by

Some of the links in this post are affiliate links. We may earn an affiliate commission if you click on a link and purchase an item we recommend. This doesn’t add any additional cost to you, but helps support our business.

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!