Today, we’re going to take a look at plantar fasciitis — one of the most common causes of heel pain in adults. An occasionally debilitating condition — over 2 million people are treated for plantar fasciitis every year. Its cause poorly understood; early studies pegged plantar fasciitis as an inflammatory condition. However, in the last decade, it has been suggested that plantar fasciitis is actually caused by a structural breakdown of the fascia itself, caused by small micro tears.
Regardless of the cause, conservative care, like physical therapy, has proven to be quite effective in warding off preventing this meddlesome disorder.
Below, we have a few exercise that we like to implement in the clinic for anyone experiencing plantar fasciitis.
As always — if you believe you’re suffering from this condition, please seek evaluation by your medical provider!
I used to be an adventure like you…Until I took an arr– tore my ACL
Following our blog post from the previous week highlighting Achilles injury prevention, today we are going to take a look at another one of the world of sports medicine’s most recurrent injuries: the ACL tear.
ACL injuries have become a hot button topic in the world of amateur and professional sports. With 100,000 to 200,000 injuries in the US per year, this injury has become a household name — a heavyweight among orthopedic afflictions. An all too feared reality for all sports practitioners — an ACL tear can have deleterious impact on an athlete’s physical, mental and economic well being.
A Quick Look at the Numbers
It’s estimated that, in the US alone, 350,000 ACL reconstructions are performed each year.1 Athletes with a prior orthopedic knee surgery were estimated to miss more practice days on average than their counterparts, as well as have an increased rate of incident for knee injury and knee surgery overall.23
There also appears to be a correlation of the sport played, as well as gender, with girl’s soccer having the highest injury rate, slightly beating out boy’s football, which trails not too far behind; boy’s basketball and boy’s baseball were among the lowest. On top of that, here’s the most interesting part: 38% of ACL injuries occurred as a result of non-contact injuries.4
As we spoke about in our last post — contact injuries are unavoidable by nature; we can’t plan for the unexpected. But we can work to prevent non-contact injuries. Poor bio-mechanics and conditioning play a significant factor in non-contact ACL injuries and, in fact, the research shows that ACL prevention programs demonstrate a risk reduction of 52% in female athletes, and an 85% reduction in male athletes.1
How Can We Prevent These Injuries?
There are many ACL prevention programs that already exist — such as the PEP Program. In general, ACL programs strive to improve overall neuromuscular mechanics, as well as plyometrics and strength training for the legs. Below, we’ve included a few exercises we really like in regard to preventing ACL injuries. If you’re interested in a complete ACL prevention program, the internet is a pretty vast resource in regard. But, as always, check with your medical provider for more information.
The injury you’ve probably heard of — rupturing the Achilles tendon. It’s an injury that plagues professional sports in all facets; no one is immune. Just last year, following the New Orleans Saint’s acquisition of former Dallas Cowboy star, Dez Bryant, the wide receiver would go on tear his Achilles in practice, his season over before it even began, from a non-contact injury.
In Baltimore, our players are no stranger to Achilles injuries: former Ravens linebacker (it really pains us to write “former”) Terrell Suggs tore his left Achilles in 2012 and then, three years later, tore his right Achilles in the 2015 season opener. Jimmy Smith also tore his Achilles in the 2017 — ending his season.
In the scheme of things, majority of these players ultimately return to the field. By way of medical intervention — surgery, or conservative care — we can assist their recovery. But it doesn’t change the fact that we’d like to prevent these injuries from happening at all.
It’s impossible to plan for contact injuries; they are, in most cases, freak accidents, and as much as we would like, we can’t always prevent them from happening. But non-contact injuries we can try to prevent. And, the best way to prevent injuries of this nature, is by proper conditioning and strengthening the muscles associated with these tendon tears.
What is the Achilles Tendon?
The Achilles tendon is located in the back of the leg; it’s the thickest and strongest tendon in the human body. It begins around the middle of the calf and serves to connect the plantaris, gastrocnemius and soleus muscles to the heel bone.1
The tendon can take force of up to 3.9 times body weight when walking and up to 7.7 times body weight in running!2
Who is at risk, and how can I prevent it?
The Achilles tendon is also the most commonly rupture tendon — with the incidence of ruptures being in the range of 5-10 per 100,000 people.3 Barring the obvious young athletes, the population most at risk for Achilles tendon injury are actually men in their 40s.4 Think of the weekend warrior type person — they’re trying to play a pickup game of basketball — and all of a sudden, they feel a pop in their lower leg.
Below, we’ve prepared a few exercises for conditioning: strengthening and recovery in the context of the achilles
You’ve probably heard of shin splints — heck, you’ve probably experienced them. Shin splints are incredibly common, and they affect athletes in a multitude of disciplines; running, dancing, gymnastics, just to name a few. The term is thrown around so frequently, it begs the questions, what are shin splints exactly? Barring the obvious “it’s just pain in your shins,” shin splints are an overuse injury that can cause micro tears and inflammation in the soft tissue surrounding the bone lining of the tibia. Many factors, such as muscle weakness and even the shoes you wear can contribute to the development of shin splints.
Strengthening and Recovery
We’ll spare you all the of the usual platitudes associated with posts like these — today, we’ll move straight to the strengthening and recovery component.
Here are two easy and novel exercises that you can add to your workouts, to hopefully help ward off the ever vexatious shin splints.
Mike Kadar wanted something different — as the strength and conditioning coach for the Pittsburgh Penguins, he was searching for a way to train himself and his athletes in a way that would functionally pertain to their craft. Mike sought the expertise of Kregg Koch — a design engineer for NASA’s Space Shuttle Program — to turn that desire into reality.
The Core Stix would become the fruits of their labor; the brain child of these two individuals. Its design based on what they a call a simple, yet profound philosophy:
No one has ever shot a puck, taken a three-pointer or thrown a touchdown lying down, so why are so many core exercises done with your back on the ground or in a seated position?
Usable strength comes from your ability to directly tie your training motions to real-life performance movements, which means you need to train standing up to get optimal results.
Applying the same principals of upright functional training to healing and recovery, physical therapists and seniors quickly started incorporating Core Stix into their routines in order to provide a safe and stable way to build usable strength.
Here at Gold Medal, we couldn’t agree more. Which is why the Core Stix have become such an integral part of clinic, for all of our patients, no matter their age or activity level.
Whether we’re working on functional strength — rehabbing young athletes to return to sport, or providing our elderly patients with exercise progressions, the ever innovative Core Stix knows no bounds. We couldn’t be more proud to offer this at our clinic.
Below, we’ve taken some videos showcasing the versatility of the Core Stix, as well as a companion video to accompany the post.
Warming up is an art that presents itself in many forms. Anything from cardio to stretching, and many other countless activities come to mind, in the context.
But for our blog post today, we’re going to be talking about dynamic stretching and its impact on your workout.
What are Dynamic Stretches?
The most common type of stretching you’ve probably heard of is ‘Static Stretching’. Static stretching refers to holding a muscle under tension — in a specific position — until a stretch is felt, and rinse and repeat. On the other hand, dynamic stretching involves moving the limbs through their full range of motion, and is repeated several times. An excellent an example of static stretching is something like the doorway stretch for your pecs, as shown below. Whereas an alternative and more dynamic stretch, would be these foam roller snow angels, also shown below.
The Case for Dynamic Stretching
Now that we have an idea of how these two stretching sub-types differ, you may be wondering, why should I consider dynamic stretching?
Static stretching and Dynamic stretching have both shown efficacy in increasing range of motion.12 But here’s where the two really start to contrast: while such a benefit to range of motion can be attributed to both, some studies actually suggest that static stretching may decrease overall performance prior to a workout.34 And in some cases, dynamic stretching has been shown to even increase overall power output.5
Given the potential for increasing range of motion and a potential boost to overall power output, athletes may want to consider dynamic stretching as a regular part of their warmup. In fact, a 2012 meta-analysis published in the International Journal of Sports Physical Therapy had this much to say:
…To increase ROM, all types of stretching are effective, although PNF-type stretching may be more effective for immediate gains. To avoid decrease in strength and performance that may occur in athletes due to static stretching before competition or activity, dynamic stretching is recommended for warm-up.6
Below, we’ve prepared some examples of dynamic stretching that you could potentially include in your warmup, depending on the activity.
It’s a sport etched in the very heart of our country’s history; it brings us joy and — more often than not — can have us feeling downright dejected. And here in Baltimore, we know a thing or two about the latter…
But regardless, countless kids each year will step up to the plate for the first time in their lives with hopes of emulating their favorite players. Many will find a quick exit from the sport; but some may continue into their High School years, and others may venture past that to achieve even greater success. For those that continue, injuries will be — just like any other sport — part of the game.
When we think injuries, one position in particular brings to mind a myriad of orthopedic affliction: the pitcher.
Young pitchers are in a particularly tough spot. They’re at risk for serious injury, with no clear cut reasoning as to why.1 Many signs point to limiting the inning count to lower than 100 per season, and barring pitchers from playing catcher, as a means of reducing these injuries; and other concepts, such as pitch count, arm angle, and throwing a curveball have become topics of contention in the context.
Perhaps most famous for injuries such as the “Tommy John” (Ulnar Collateral Ligament Sprain), pitchers are also no stranger to the likes of Rotator Cuff Tendonitis, just to name a few. And although we’ve no concrete way of preventing such maladies from happening, proper movement and strength screening, such as Functional Movement Screening (FMS), or Selective Functional Movement Assessments (SFMA), can help to identify areas of problem. With such knowledge in hand, practitioners could focus their efforts on what they need most.
Cue the concept of ‘prehabbing’
Pitching is one of the most complex arts in the world of sports. Similar to the golf swing, for example; it requires timing between the arms, legs and torso, to achieve consistency in the most efficient manner. Lacking the required strength, endurance and mobility in the muscles utilized to execute these movements, plays a role in the breakdown of mechanics as the inning/pitch count rises. Distance running, the long toss, and dynamic exercises that target both the upper and lower body musculature, should be emphasized.
Below, we’ve prepared some awesome exercises and recovery techniques that may help you through the season!
The Prone “Y” & Squats
The Posterior Capsule Stretch & Instrument Assisted Soft Tissue Massage
Perhaps the most famous verbiage in a gym rat’s arsenal.
And perhaps for good reason — because what would the world of powerlifting be without the bench? It’s the quintessential exercise; it’s the one everyone and their grandmother knows in the context of lifting.
While not being as flashy as the snatch or clean and jerk, it’s still a complex movement with a lot of variables to consider when performing. Your chest, arms and shoulders are all an active component — and focusing attention onto these areas independently can give you that true strength to help you reach your potential with this exercise.
These are are a few exercises that we really like as supplemental work or as substitutes when dealing with pain.
The Floor Press
The Floor Press is the absolute bomb, especially if you’re having shoulder pain or are limited by your shoulder in general when performing the bench. It’s great because it requires you to push through a smaller range of motion to perform. If you’re rehabbing your shoulder, for example, this would be a great replacement for the bench.
The Dumbbell Chest Fly
Awesome supplemental exercise to train your pecs for hypertrophy — with dumbbell in each hand, the chest fly allows you to train each arm independently. Time under tension is important to keep in mind when performing this exercise.
The Close Grip Press
The close grip press can be a great supplemental exercise to train your pecs for hypertrophy, also. Think about pressing the dumbbells together throughout the movement. Time under tension is, again, important to keep in mind when performing this exercise.
The year is 2016 — the stage is set at the Giants Live World Deadlift Championships. Eddie Hall is poised to make history — becoming the first man to deadlift 500kg.
The strain of the lift so great, Eddie would pass out almost immediately after.
While this is on the extreme side of weight lifting — the deadlift at its core is the same at all skill levels. If we were to break it down further, we can isolate the mechanism to the hip hinge.
The hip hinge is the fundamental pattern when lifting anything heavy off the ground. And the range can apply to all weight levels; from lifting a heavy box from the ground to Eddie Hall deadlifting 500kg — the hip hinge is the most efficient and safe way to lift.
Below our some of our favorites for showcasing the hip hinge.
The Austrian Oak, introduced in 2012 at the Arnold Strongman Classic, is among one of the most interesting lifting events in the modern era. The oak — beautifully crafted entirely of wood — varies in weight yearly, but can typically reach excess of 460+ lbs.
Competitors are not only tasked with lifting this monstrosity from the ground, but they must attempt to press it overhead. Any competitor unable to press the oak is given a “lighter” variant weighing in at around 375 lbs.
In 2015, Žydrūnas Savickas sought to defy all logic by pressing the oak — which was particularly heavy that year, weighing in at 503 lbs — not once, but a total of four times. Žydrūnas would solidify himself as the world record holder for the event, and the only person that year to rep the giant log even once.
The overhead press is an incredibly complex movement, and while Žydrūnas Savickas makes it look easy, it’s important to take into account all of the muscles that are connected to the shoulder.
Although you don’t need to press the Austrian Oak, the following exercises we’re about to show you can impact your ability to lift objects overhead, whether that’s on the scale of putting dishes in the cabinet, or snatching, clean and jerk and the overhead press.
Developing the many muscles of the rotator cuff is integral to developing true shoulder strength. This set of exercises is meant to challenge the rotator cuff and its surrounding muscles. The following exercises are as follows:
Sidelying External Rotation
Sidelying Shoulder Flexion
Sidelying Horizontal Abduction
Not only is it important to build strength in the shoulder, but it’s just as important to build mobility in the shoulder so you can use that strength. These exercises put a focus on improving that shoulder mobility. The following exercises are as follows:
Overhead Loaded Cane/PVC Pipe Flexion
Supine Thoracic Extension (Remember: the thoracic spine is tied to shoulder girdle mobility!)