Runners’ Knee

What is it?

Runner’s Knee isn’t a pathology itself but rather a vague term to describe a number of conditions that plague runners, cyclists, skiers, soccer players ect. Runner’s knee typically refers to one of the following conditions: infrapatellar tendonosis, patellofemoral pain syndrome and chondromalacia patella.

Symptoms often consist of pain while running hills or stair training, poorly localize pain around the knee, RARE swelling, typically gradual onset and “movie sign”, increased pain after prolonged sitting with knee flexed, relieved by straightening leg.

What causes it?
Overuse/overtraining: Repeated high intensity bending of the knee can irritate the muscles, nerves and ligaments surrounding the knee.
Direct trauma: I don’t think I need to say much here.
Misalignment: From the waist down there are several areas in which excessive stress can be placed on the knee due to misaligned bones/joints. This is not just a theory in the chiropractic profession; take a look at WebMDs article on runner’s knee.
Muscle imbalances: For several different reasons we develop asymmetrical movement patterns that over time, cause muscle imbalances that begin to add stress to one knee. You should be thinking (if the injury is not a result of trauma) why my right knee and not the left or vice versa.
Treatment.
If you have read this far I’ll take a wild guess that traditional Protect.Rest.Ice.Compression.Elevation.( P.R.I.C.E.) treatment has not worked, so I’ll skip it. The follow list is in no particular order of importance. I’m simply listing the treatment options that I would send my mom to.
1. Cross train/ Strength training- I often ask runners what training they do besides running and often running is their only source of physical activity. Creating an intelligent stretching, cross-training program and/or strength training program will often resolve the issue. Find a well qualified personal trainer. A few of my favorite training facilities in the Portland Metro:
**The Egoscue Method clinic: http://www.facebook.com/egoscueportland
**Muscle in Motion: http://www.mymusclesinmotion.com/

2. Sports massage or active release technique (ART). ART practitioners are highly trained health care professionals (typically Doctors of Chiropractic) that can identify muscle imbalances and joint misalignment. There is a reason why the NFL, MLB, NHL and NBA now have ART practitioners on their treatment squad. Follow link below to learn more about ART. http://tigardchiropractor.wordpress.com/what-is-active-release-technique/
3. Address your foot needs. For podiatrist in the Portland metro I highly recommend Dr. Ray McClanahan: http://nwfootankle.com/
He will change the way you think about feet and footwear.

4. Find a running coach. Running is a sport, the most popular sport in the world in fact. Why not find someone that devotes their life to teaching others how to run injury free? Alice Peters Chi Running coach is who I suggest in the Portland Metro. http://www.runningmindfully.com/
I can’t say enough great things about what she is doing.

If you have any questions or comments don’t hesitate to email me at drrhodes@accelerationchiro.com or call at 503-567-3456.

Best wishes,
Tony Rhodes DC, ART

Active release technique

Plantar fasciitis

Have you ever stepped out of bed after a nice relaxing night of sleep and felt a sharp, burning pain on the bottom of your foot? The pain improves as the tissues warm up and as your day progresses, but it never seems to go away. The condition I’m discussing today is plantar fasciitis or plantar fasciosis, depending on who you are trying to make happy. The plantar fascia is on the bottom of your foot, it runs from your heel to your toes. In the picture above you can see it’s attachments with the Achilles tendon, this will come into play shortly.

In athletes, simply over stretching or over use of the plantar fascia can be a cause. Usually P.R.I.C.E. treatment will do. Conversely, the condition often appears in high heel wearing, overweight- middle aged females with a sedentary lifestyle. The cause here is quite different. Look at the picture below. The artist has placed the foot in a position similar to how a foot would set in a high heel. Notice the big toe is slightly extended upward and the ankle is in a plantar flexed position. This puts a significant amount of strain on the plantar fascia. To make my point more clear, put your palm on your desk, point your elbow toward the ceiling, with your opposite hand pull one of your fingers toward the ceiling until your start to feel discomfort in your palm. A similar strain happens as a result of wearing high heels, but all day long. Now take that foot out of the heel, let the fascia relax for 8 hours, then rapidly stretch it....stabbing morning pain begins. Overtime you develop inflammation, hypoxia and scar tissue formation occur resulting in chronic plantar fasciitis.




Look again at the picture above. The heel is off the ground. This places the calf and/or the Achilles tendon in a shortened position, creating tightness and weakness. There is a research article showing Achilles weakness as a result of wearing a heel. Women you are not alone. Men, take your shoe off and place it on the desk. 90% of you will notice there is some type of heel lift (especially in dress shoes) and a toe spring (very front of the shoe that curls upward). This is doing the same thing as the high heel but to a lesser degree. I hope I have facilitated your thinking a little outside the shoe....

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New ART Video

Active Release Techniques - long video from Jay Ferguson on Vimeo.

GRASTON

Dr. Tony Rhodes D.C., ART