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Showing posts with label knee pain. Show all posts
Showing posts with label knee pain. Show all posts

Friday, January 29, 2016

Glutes - How to Transition From Exercise to Run

You've been told you have weak glutes. Whether it's hip pain, knee pain, ankle pain, it all can be "healed" by improving glute strength. You are prescribed clams, side lying leg lifts, bridges then progressed to squats and lunges. You feel stronger and released to go for a run. Your symptoms feel better but returns after getting back to your routine.

Recruiting Glutes vs. Quads

Is your strength transferring from a basic clam exercise to running? Are your glutes REALLY activating when you run? For most of us, we are very quad dominant. This means we over use our quadriceps when we should be using other muscles such as our glutes. Our sedentary lifestyle of sitting at work or relaxing on the couch has us disengaging our glutes. The quads have at a mechanical advantage to work. Also, the habitual use of quadriceps enhances the neural input from the brain is going to the quads and not the glutes. In other words, the wiring to the quads is better then wiring to the glutes. When running, demand on the muscles is so high we use whatever muscles are the easiest to recruit. The Quads.



I have seen and used different cues such as "stick out your butt"or"squeeze your butt as you stand up". However, most of my patients and clients have a difficulty "feeling the exercise". AND, the improved strength doesn't seem to translate to running.

PUSH YOUR KNEES BACK

I have been using a different cue to activate the glutes while performing standing exercises such as squats and lunges. While you are performing squats or lunges (or any standing hip exercises i.e. box step ups), pretend like there is an object behind your knee and push back as you stand up. The gluteus maximus is responsible for hip extension, getting your thigh behind you body. However when your foot is fixed on the ground and the knee is given the cue to push back, this extends the knee AND hip. This will engage your gluteus maximus.




Stand up and perform a squat. When you stand up, you feel your thighs press down into the ground and push up. Now try a squat but give the cue for your knees to push back.

FEEL the burn in your glutes.

Now, think of this cue when running. You want to let your knee land normally (with a soft bend), then push back with the knee as your body is moving over your leg. You should feel like your legs are moving in a circle, almost like pedaling a bike. At first, I recommend incorporating this during a warming up, then into sides and finally into your short normal runs. The best way to feel this is up hill sprints!
THIS CUE WORKS BEST IF YOU MIDFOOT OR FOREFOOT STRIKE!

So on top of performing clams, leg lifts and squats add this "push your knee back" cue to the standing exercises.

Please contact me if you have any questions or concerns.

Thursday, January 1, 2015

3D Calf stretching

With the New Year comes resolutions to run faster, longer and stronger, yet shortly into your New Year's Day run, your foot, ankle and/or knee starts to ache. You're tough and want to stick to your new years goals so you keep going, but what gives? How long is this going to last? Is this going to turn into an injury which may impact your 2015 goals?

For females, our ankles and calves get tight from wearing high heels during the New Year's Eve celebrations. Yes, just those few hours of wearing heels can have long lasting effects on the mobility of your ankle. Males who wear certain styles of dress shoes are also prone to having tight ankles which impact mobility. The limitation in mobility can alter your mechanics leading to ankle, knee, hip or even back pain.

                                   
                                   




Here are a few ways to keep your ankles and calves mobile to help you stay on track to reach your running goals.

Lacrosse Ball Roll 



Compression Band for the Calf


 * a bike tube cut into a long strap and down the center can be used if you don't have a compression band. Use for no more then 2 minutes.

Calf Stretch




Friday, August 15, 2014

Compression Band for Plantar Fasciitis, Ankle Sprains and Knee Pain

At the request from multiple people, this post is focused on how to use a compression band (voodoo band) for the lower extremity. The feedback I receive after being wrapped is the treatment area feels lighter, more mobile and less achy. This is does not fix an injury but a way to manage your symptoms.
On the left is a home-made compression band from a bike tube.
On the right, is the compression band aka. voodoo band

How the compression band works

The band works by providing a compression onto the connective tissue. Imagine our connective tissue as a kitchen sponge. When it is being used, the sponge soaks up dirt and grime. When the sponge is compressed the dirty fluid is squeezed out and upon release fresh water is absorbed. By pushing stagnant fluid out and allowing fresh fluid to enter, our soft tissue is lubricated and mobility is restored! Drink Water!



How to use the compression band


Stretch the band about 50-75% and cover half of the prior band. I recommend performing stepping motions in all 3 planes of motion to maximally compress the different aspects of the connective tissue. The band stays on for no more then 2 minutes maximum!
DO NOT use the band if you have peripheral vascular disease, peripheral neuropathy or being treated for cancer. Take the compression band off if the tissue becomes gray, have numbness and tingling or have sudden claustrophobia

The band can be purchased online or you can cut a bike tube in half and split down the middle for a flat band. Note: A bike tube is much shorter then the 7-foot band and you'll smell like rubber.

I will demonstrate on to use the band for the lower extremity - foot, ankle and knee. 
The band can help reduce symptoms associated with plantar fascia, ankle sprains, Achilles tendonitis and general knee pain. 


Plantar Fasciitis 

Start the wrap at the base of your toes and wrap around the foot and onto the ankle. Tuck the end in. You can perform toe curls and extensions, ankle pumps and ankle circles. For the best effect perform a lunge matrix. 

Ankle Sprains and Pain

For ankle sprains, start the band the base of the ankle. Always start the band distal to the ankle to push the swelling into the leg to be absorbed. You want to cover the skin as much as you can so the swelling doesn't get pushed into the uncompressed area. Covering the entire surface around the ankle can be tricky. I recommend completely covering the heel with one circle and angling the ankle down.

This method can also be used for Achilles tendonitis.

Knee pain 

Start the band below the kneecap. You should have enough the cover the entire knee. Tuck the end of the band under the. You can bend and straighten your knee at different angles or contract your quadriceps muscles. My recommendation...  a lunge matrix!




The band can also be used around your muscles such as quadriceps and calf. 

Please see your MD if your pain is a chronic or serious injury.


Those who have use this please comment and give your feedback!

#compressionband #voodooband #kneepain #anklesprain #achillestendonitis #plantarfasciitis # pain 

Wednesday, June 18, 2014

ANKLE SPRAIN - How the Thoracic Spine and Hip Can Contribute

Recovering from an ankle sprain appears to be pretty straight forward, however there are other factors which can hinder recovery. The two areas we will focus on are the hip and thoracic spine (upper back). Daily activities in the sitting position, such as computer use, reading and driving, etc., results in an increase stiffness in our hips and thoracic spine.
The tissue surrounding the gluteals become stagnant from prolong sitting making it difficult to generate force and absorb energy. At the same time, the hip flexors in the front of our pelvis shorten from sitting.
The thoracic spine is another region which is affected from prolonged sitting. The muscles of the thoracic spine work to fight gravity which pulls our trunk forward. Most daily activities which are performed in front of our body also contributes to increase pull forward.  To make matters worse, the thoracic spine is a difficult area to stretch due to the bony anatomy and rib cage.
Limited mobility of the hip and thoracic spine changes our biomechanics which can impair the body's ability to recover from a lateral ankle sprain.


HIP

Hip Mobility

When the heel hits the ground, the bony anatomy of the ankle generates a rotational force up the lower leg and into the thigh. At the same time, the body weight shifts from the back leg to the lead leg which produces a lateral motion of the hip and pelvic junction.
If there is a limitation of frontal plane motion of the hip, the movement will find another path. A common pathway is the ankle.  As the body shifts laterally to the front leg with a limited hip motion, the lateral movement will be forced at the ankle causing a lateral ankle sprain.


Hip Mobility Assessment


Stand with your legs hip width apart. Bring your arms up next to your head. Reach to the side as far as you can, then to the other side. Feel for any difference in motion in your hips from side to side. You may need to stand in front of a mirror or have a friend to give you feedback.


The above pictures show less mobility on the left hip (picture on the right). The larger hip/pelvis angle reveals there less motion occurring at that joint. Side note: I roll my left ankle during this run.


Hip mobility Treatment


Lateral hip stretch -



To stretch the side of the hip, stand next to a low bench or step. Place the leg across body onto the step with the knee bent. Allow the body to move over the stance hip until you feel a stretch. Use your pelvis to drive forward, sideways and twist. Please refer to the video above.


***Bonus lateral hip stretch - Instead of crossing the leg in the front, cross my leg behind my body.  Make sure the back leg does not twist the body away from the stance leg. Shift toward the stance leg. Then use the pelvis to drive the body in the sagittal plane, frontal plane and transverse plane. Please refer to the video below.








Gluteal Stretch -





Place one leg on a table ( at home I use the end of my couch, kitchen or bathroom counter) at about mid thigh to hip height depending on flexibility. The knee should be bent to 90 degrees and thigh perpendicular to body. From there, hinge forward in the sagittal plane, reach away sideways in the frontal plane and rotate towards in the transverse plane to the stretch leg. These motions create length at the hip and pelvic junction. Perform about 10 repetitions per plane of motion or until you feel improvement in flexibility.
Refer to the video above for planes of motion.
*** Hinge at the hip NOT the lumbar spine.

THORACIC SPINE

Thoracic Spine Mobility


When one leg is swinging forward, the same side arm is swinging back. The swinging of the arm backwards drives rotation of the upper back. For example, as the right leg swings forward the right arm swings backwards. A rotational motion is created at the core since the opposite leg is behind the body. This position helps to load the abdominals in a rotatory fashion, similar to a spring.
If the thoracic spine is tight, the rotation will bypass the region and the motion in transferred elsewhere. Occasionally, this force causes a shearing motion in the back. Other times, the force goes into the ankle.

Thoracic Spine Assessment

Place one leg in front of the other with the knee slightly bent. Bring your arms in front of your body at chest level. Turn as far as you can towards the front leg then towards the back leg. Switch so the other leg is forward. Feel for the rotation in the thoracic or have a friend watch for you.
Watch the video below.

 





Thoracic spine treatment


Rotation T/S stretches- These stretches improve the rotation of the spine.
To improve rotation of the thoracic spine while the arm is swinging forward - Take a step forward with L leg and L arm next to head, bring R arm in front of body and reach forward. 
To improve rotation of the thoracic spine when the arm is swinging backwards - With L leg in front and R arm next to head, swing L arm behind the body.
Refer to the video below.





To maximize the effects of the stretches, follow up with strengthening exercises. Performing strengthening exercises after stretching will stimulate sensors in the newly acquired range of motion which may have been dormant for weeks, months or years.

Stay tuned for my next post on strengthening exercises for runners!