Diagnosing Runner's Shin Pain - Nanaimo Chiropractor

Many a runner has been sidelined by shin pain. Often, the runner puts the pain down to "shin splints" and proceeds with rest and ice. But did you know there is more than once condition in runners that cause shin pain? Do you know which one you might have? Nanaimo has a large running community and we at Pure Chiropractic are here to serve them.

Anterior Compartment Syndrome:
Muscles at the front of the shin are enclosed withing a connective tissue (fascial) sheath known as the anterior compartment. This sheath does not have a lot of flexibility to it. When running, the muscles become "pumped up," filling with blood. This increases the muscles' volume. Given the inflexible nature of the sheathing, pain ensues. Pain classically comes on shortly after the beginning of the run and will reduce significantly after 30 minutes of rest. This condition is often seen in runners that are rapidly building their distance, perhaps because the fascia has not had time to expand with the muscle development. At rest, the muscle is minimally tender to touch. Circulatory symptoms to the foot are possible, such as coldness or tingling/numbness.

Medial Tibial Stress Syndrome:
Pain along the bony shin is most likely Medial Tibial Stress Syndrome (MTSS). The tenderness is thought to be caused by muscle pulling on the outer layers of the bone, causing irritation. Pain is typically present at the beginning of the run, easing as the run progresses. Pain then returns when the runner is at rest, often hours later.

Stress Fractures:
Stress fractures appear very similar to MTSS. Stress fractures are when cracks form in the bone from the heavy demands of running. Pain is felt along the tibia, or shin bone, typically the lower 1/3. Pain is present at the beginning of the run and increases as the run progresses. The bone is tender to touch at rest.

It's crucial to get the diagnosis right as treatment is dependant on the condition. The only way to be sure of your diagnosis is with a thorough examination. X-ray examination may be necessary and we have digital x-ray facilities on site. Seek professional advise from someone experienced in sports injuries.

I'm Dr.J, helping you "Get Back to Life."

Pure Chiropractic
Nanaimo
250-585-8866


















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VI Raiders / Nanaimo Timbermen Team Chiropractor

We at Pure Chiropractic, Nanaimo, have some very exciting news. Our clinic has been named team chiropractic clinic for the VI Raiders and three of the Nanaimo Timbermen Lacrosse teams (Western Lacrosse Association Senior A, Nanaimo Junior A, and Nanaimo Intermediate)!

The Raiders are three time CJFL champions (2006, 2008 and 2009). They have also won 6 consecutive BCFC titles in 2006, 2007, 2008, 2009, 2010 and 2011. BC Lion, Andrew Harris, whom was named Most Outstanding Canadian of the 99th Grey Cup is a former Raider. 2012 promises to be an awesome year! On top of providing chiropractic serviced to the team, Dr.J is proud to be added as director to the team board.

Very recently, Senior A Timbermen owner, Hadi Abassi, aquired the Junior A and Intermediate teams. It's exciting to see all three teams under the same umbrella and it makes for a promising future for lacrosse in Nanaimo. The 2012 season kicks off with a home game against Langley Thunder on May 20th. Hope to see you at the Frank Crane Arena!

With nearly all professional sports teams within the NHL, CFL, NHL, NBA and MLB using chiropractic to keep their players not only injury free but also playing at peak performance, our relationship with these teams just makes good sense. We look forward to helping these guys achieve something great!

Regards,

Dr. Jason Hare

Pure Chiropractic

1-5144 Metral Drive, Nanaimo

250-585-8866

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Nanaimo Chiropractor - Keep Skiing Injuries Away

Ski season is truly upon us. That means fresh air, lot of fun and exercise. Unfortunately for some, it also means injury. Many a chiropractor are kept busy during the winter months treating skiing injuries, including us at our Nanaimo chiropractic clinic, Pure Chiropractic. I would like to help you stay injury free this ski season. As such, here are 6 easy tips to keeping ski injuries away.







Six Tips to an Injury Free Ski Season:

1. Professional Instruction. Don't be cheap. Yes, a day at the slopes is expensive, but if you are new to skiing or it's been a while don't scrimp on the lessons. You've got a friend who's a really good skier and promises to "show you the ropes?" Being good at something doesn't mean you're a good teacher. You need to know what you're doing on the hill or you're just asking for trouble.
2. Know your limits. You've had your lessons and you know how to ski. Nothing can stop you! You're friends are encouraging you to try the black diamond run, saying it's "easy." It's best to know your limits.Tackling a run that's above your ability is a god way to get in trouble.
3. Warm up. Sounds basic, doesn't it? Yet most people don't do it. Cold muscle is less flexible. Make a quick turn and you can tear the muscle or it can pull on your joint. Wear appropriate clothing. Do some basic stretches before you head up and do a couple of easy runs before you tackle a more technical run.
4. Core Stability. Skiing and boarding require a lot of torsional (twisting) movements to your body. This is not an action that most people do in the gym. Think about it. On all those cardio machines we keep our bodies straight. When lifting weights we keep our bodies straight. Then we head out to the hill and twist our bodies and wonder why our back hurts when we're "in such great shape." You need to do some core stability work before and during the ski season. Join a yoga class, a pilates class or one of your gym's core stability classes. Find which one you enjoy the most and stick with it.
5. Pay attention to fatigue. It's a familiar story in our chiropractic clinic. You've been out all day having a blast and decide to go for one last run. That's when the injury happens. As your muscles fatigue, they do their job poorly. Balance, agility and stability are affected. To remedy this, take regular breaks and keep hydrated /eat through the day. Be honest with yourself, when you're tired you should be done for the day.
6. Chiropractic. You didn't expect a chiropractor to not write about chiropractic, did you? Chiropractic is not only a big part of injury treatment, it can also be an important part of injury prevention. Lack of joint mobility puts the body at risk of injury. Before you head out to the slopes, head into your chiropractor's office. If you'd like to see us at Pure Chiropractic, Nanaimo call 250-585-8866.

Hope you've found this blog post helpful. Leave a comment below and give your tip on preventing injury on the ski hill.

Kind Regards,
Dr. Jason Hare, Chiropractor
Pure Chiropractic, Nanaimo
1-5144 Metral Drive Nanaimo
250-585-8866


Photo Credit: http://www.freedigitalphotos.net/images/Outdoor_Sports__Land_g220-Ski_p11773.html

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Nanaimo Chiropractor ~ Vitamin D to Beat Muscle Injury

I've come across a new research study that I wanted to share with you. This study looked at Vitamin D levels and the NFL players that have lost time to muscle injury. As part of their pre-season routine examinations, 85 NFL football players had their Vitamin D levels taken. Normal levels are considered to be 32 ng/mL or higher. Then, the amount of time each player lost to muscle injuries was tracked throughout the season. The study found that the athletes that suffered a muscle injury had an average vitamin D level of only 19.9 ng/mL!

Now, let's look at this to figure out what it means. First of all, I'm shocked that a highly paid professional athlete would have dietary deficiencies at all. I mean, their bodies are their lively hood for goodness sake! But that aside, does it mean that low vitamin D levels mean you are more likely to see injuries? Maybe. The study didn't mention if their were any other dietary deficiencies, but it's certainly possible that if the athletes were low in vitamin D they may have been low in other nutrients. Should we make sure we have adequate vitamin D levels? Absolutely!

Some vitamin D facts:

• It's important  for bone density (preventing osteoporosis)
• Normals levels prevent heart attack and make it more likely to survive one if you do have one.
• Colon, breast and ovarian cancer have been linked to deficiency
• Good levels of vitamin D have been linked to a stronger immune system.
• Alzheimer's patients have lower vitamin D levels (unknown if this is a cause or result of the disease)
• Good vitamin D levels result in less falls in the elderly.
• Has been suggested to be linked to mood, depression and cognitive function.

Wow! With all those benefits, we certainly should make sure you get enough. So where do you get vitamin D? In the summer, your skin will make vitamin D when exposed to the sun. However, in Canada you do not get enough sun exposure in the winter to meet our body's requirements.

Milk, and most soy and rice milks, are fortified with vitamin D so you may be getting your requirements there. Dietary sources include oily fish (cod, salmon, tuna), eggs and liver. Unfortunately, you would have to consume large quantities of these foods to meet your requirements. Normally, I'm in favour of getting good nutrition through really food, not tablets, but if you vitamin D is one time that we must supplement if you don't drink milk or milk substitutes.

I would be remiss if I didn't point out that you must follow recommendations when taking vitamin D supplements. The recommended daily dose for an adult is 600-800 IU/day. 4000 IU/day is considered the upper tolerable limit for this vitamin and you will see the effects of toxicity above these levels.

Hope this was informative. Remember, good nutrition is one of the keys to injury prevention! If you do end up with an injury, why not give us a call at Pure Chiropractic 250-585-8866.

Yours in Health,
Dr. Jason Hare
Nanaimo Chiropractor


Photo Credit:
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Nanaimo Chiropractor ~ 4 Reasons Why Forefoot Running is Rubbish

If you pick up any running magazine these days, you're bound to come across one of the latest trends: forefoot running. Several methods have been created around this concept, Chi Running, Pose Running and the Evolution Method to name the more popular incarnations. Although slightly different in their methodology, the basic concept is the same, namely that when running you strike with the forefoot instead of the more conventional heel strike.

Many supporters claim that is method is the best method for running, saying that it has less injuries and is more efficient. I think we should look at these claims.

1. Ok, so forefoot strike running is supposed to be the best. Logic would then tell us that the majority of elite runners would use this method, correct? Research done at Sapporro International Half Marathon  found that of 283 runners, 75% did a heel strike, roughly 25% had a mid-foot strike and roughly 1 % (4 out of 283 runners) did a forefoot strike. None of the forefoot strikers were in the top 4 positions. Do all those elite runners have it wrong? Hmmm... makes you wonder, doesn't it?

2. Many proponents of forefoot running claim that there are less injuries with their method. Let's be clear on this, THERE IS ABSOLUTELY NO RESEARCH THAT SHOWS FOREFOOT RUNNING TO HAVE LESS INJURIES. End of discussion. If anything, I see an increase in difficult-to-treat forefoot joint problems in forefoot runners in my chiropractic clinic in Nanaimo.

3. Let's look at how you naturally run. If I asked you to sprint across the parking lot, you'd run on your forefoot. If I asked you to run to the neighbouring town, you'd run with a heel strike. What makes us think we can improve on what our bodies naturally want to do? Yes, there is some research that says that barefoot runners tend to run more on their mid or forefoot, but barefoot running is a whole other discussion (perhaps a future blog post).

4. Finally, let's look at anatomy. There are a series of bones in the ankle. The bones at would absorb impact with a heel strike (the talus and calcaneous) are big and dense. Those that absorb impact with forefoot running (the cuboid and cuneiforms) are much smaller, roughly the size of an ice cube. Doesn't it make sense that the larger stronger bones are the ones designed for impact?

Don't follow the trend, follow your brain.

If forefoot running works for you, great, keep doing it. If you're thinking about changing your running style, think long and hard. Those promises of faster times and less injuries may be unfulfilled. Let's not try to re-invent running. I know this is a controversial topic. Leave a post below and let's have a discussion. If you have a running injury, why not contact us at Pure Chiropractic, Nanaimo, 250-585-8866.


Regards,
Dr. Jason Hare
Nanaimo Chiropractor




Photo credit:
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3 Common Workout Mistakes - Nanaimo Chiropractor

As a person who is passionate about health, I love hearing about people taking up an exercise routine. But there are pitfalls that we can make. I'd like to cover three of the most common mistakes:

1. Doing the same routine: There's a number of reasons for not doing the same routine day after day, week after week. First of all, it's boring! Unless you have an amazing will power, you will lose interest in your routine and you will find yourself not keeping up with your exercise.
   
   Secondly, you'll burn less calories. As your body becomes more efficient at a skill, you will burn less calories to do that skill. For example, a poor swimmer will expend more energy to swim a length than a world class olympian.
   
   Also, you will plateau in your training if you use an unchanging routine. Want to improve your running speed? Mix it up. Vary between trail runs, some hill sessions, and some track/interval work. By challenging your muscles in different ways it becomes more versatile.
   
   
2. You only do cardio. I'm the first to espouse the benefits of cardiovascular exercise but there are hugh benefits to including a weight routine in your exercise program. Your muscles are your calorie burning engine. Even at rest, muscle burns calories. More muscle means more calories burned, even at rest. This is why low calorie diets fail. If you lower your calorie intake too much, your body will start breaking down your muscle tissue for energy, thus decreasing the size of your calorie burning engine. Those starvation dieters then try to go back to a normal food intake and gain all their weight back.
   
   Also, weight bearing exercise is THE best way to reduce the risk of osteoporosis. Most people have a good calcium intake. And the osteoporosis drugs don't do a great job, plus they have side effects (including esophageal cancer and, unbelieveably, fractures). The body follows the old saying "Use it or lose it." By using your bones in weight bearing activity you give your body the best possible chance or reducing your risk of osteoporosis, or brittle bone disease.
   
   
3. Staying in the fat buring zone: Many people only exercise at low intensity, the so-called fat burning zone. You see, at lower heart rate exercise your body burns a larger percentage of fat for energy. As you exercise harder, you burn proportionally less fat and more carbohydrate. Because of these facts, many people stay in the lower heart rate zone thinking they will burn more fat. The fact that is overlooked is that although higher intensity exercise burns proportionally less fat, more calories are burned overall, meaning more fat is burned overall.

There's lots of other workout mistakes. Why not leave one in the comment section below?

Thanks for reading! Dr. Jason Hare, Chiropractor at Pure Chiropractic, Nanaimo


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A Runner's Nightmare: Iliotibial Band Syndome - Nanaimo Chiropractor

Hi there. For this post, I thought I would cover one of the most common running injuries: iliotibial band syndrome or  ITB syndrome. Many a runner has been sidelined for long stretches of time by this condition, so let's give you the information you need to sort it out.

The iliotibial band, is a connective tissue sheet that runs along the outside (lateral) thigh. It connects to the crest of your pelvis (where you would put you hands if I said put your hands on your hips) to your shin bone (tibia) just below your knee. The IT band's anatomy is comlex but it's main job is to stabilise the knee. Most people are blissfully unaware of the IT band's existance until it starts givng you pain: iliotibial band syndrome.

The syndrome typically gives pain on the lateral aspect of the knee, especially if running downhill or walking downstairs. Other than a sprain, little else will give you pain on the outside of your knee, so it makes diagnosis pretty easy. At the upper outer thigh, the ITB passes over the greater trochanter, which is a bony prominence of the femur close to the hip joint. If the ITB is tight it may rub against the greater trochanter and give upper "hip" pain. The ITB can alsocause a "hip snapping" which is an audible snapping that the ITB makes as it moves over the greater trochanter when walking.

Some of the possible contributing factors for ITB problems are:

• Over pronation, which is when people have a low arch to their foot.
• Building running distance too quickly.
• Too much hill work.
• Tight glutes. The Gluteus maximus attaches into the ITB. If it's tight it can be a complicating factor.
• Pelvic misalignment: If the pelvis has misaligned the ITB may be pulled tighter on one side. This MUST be especially considered if the ITB syndrome is on one side only. Overuse generally produces ITB syndrome on BOTH sides.

Note the asymmetry in the pelvis in the x-ray above. This will pull the ITB tight on one side, leading to unilateral ITB syndrome.

Effective management of this condition includes:

• Proper footwear, but you already know the importance of having the right shoe, don't you?
• Rest or ease back from running with a slow build into hill/stair workouts.
• Ice the ITB to reduce inflammation. 20minutes / hour is a good guideline. Be sure to place a T-shirt or tea towel between the ice pack and the skin. Avoid anti-inflammatories as they can actually lead to injury.
• Stretch the ITB. A good sports chiropractor should be able to give you a couple of good stretches for this. *NOTE* this is an extremely thick piece of connective tissue and is not a muscle. It requires dedicated work and gives slow progress. I'm a big fan of take-home stretches as soft tissue work done occassionally in the office simply isn't enough.
• Stretch the glutes. No, tight glutes aren't always the cause, but it doesn't hurt to stretch them out.
• Address the faulty pelvic mechanics. This is where your chiropractor comes into play. If possible, try to find one who has a good working knowledge of sports injuries. Again, consideration of a pelvic misalignment is essential if you have ITB syndrome on one side only.

I've treated this condition a LOT. If you have any questions, why not give the office a call, Pure Chiropractic, Nanaimo, 250-585-8866.

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