Dry Needling now available at Performance Sports & Wellness

William Weinstein, L.Ac., Licensed Acupuncturist (located at Performance Sports and Wellness with Dr. David Ness), is now certified in Integrative Systemic Dry Needling for Sports Injuries and Trauma Rehabilitation by the American Dry Needling Institute. Dr. Yun-tao Ma, institute director, is an internationally respected expert in the field, teaching in Europe and China as well as the U.S. Dry needling is currently a sought-after treatment modality in use by professional and Olympic athletes around the world. See www.weinsteinacu.com for more information or call 845-255-2070. Find information about dry needling at http://dryneedlingcourse.com/.

Gift ideas from Dr. Ness

This year give the gift of self Myofascial release with a Foam Roller.  Foam rollers make great gifts for runners and other athletes.  We also offer Titleist Golf Fitness exams gift certificates.  Dr. Ness is certified by the Titleist Performance Institute.  The golf fitness exam can help identify musculoskeletal imbalances that lead to golf swing faults.  Our package comes with the exam, swing video, 2 training sessions, and online exercise program from the Titleist Performance Institute.

Consequences of an unsupported flat foot

As someone who takes care of a wide variety of athletes, I get to see a lot of people who participate in various sports come in with many types of repetitive or sometimes traumatic injuries of the lower extremities.  One of the most common causes of repetitive strain injuries to the lower extremities is people who are pronated or flatfooted.  If you are a pronator and you know it, and you do not use arch supports in your sneakers when you run.  You open your self up to a wide variety of injuries as a result of the altered biomechanics of the foot.  Just a few of the possible consequences that can be a result of running without the proper support are; shin splints, plantar fascitis, knee pain, ITB pain, hip pain, and lower back pain.  These areas can become injured or over strained due to the compensations that happen posturally above the foot to make up for the altered biomechanics from the foot.  Over time arthritis of the bones of the foot and toes, and other deformities of the foot like bunions, and hammertoes often accompany an uncorrected or unsupported pronated foot.

 

The risk of a Triathlete suffering any of the above is not uncommon during a season or career.  If you are a person who chronically suffers from plantar fascitis, shin splints, runners knee, ITB syndrome, or any other lower extremity or back injury the sooner you get into the right store bought support or custom made arch support the sooner those chronic aches and pains may go away.  Lower extremity aches and pains that do not go away with conservative treatment like orthotics, foam rolling, massage, or physical therapy could be a sign of adhesion and scar tissue build up in the muscles above the foot.  This is due to the long-standing altered biomechanics in the foot; in addition to the rigorous and repetitive training that triathlete’s endure.

 

One of the worst consequences of an unsupported flatfoot deformity in someone who is active is a stress fracture.  Stress fractures can occur in any of the bones of the foot, ankle, or leg.  As I sit here writing this article I have a cam walker boot on my foot due to a stress fracture of my Navicular bone in my foot.  I will have to wear this for 4-6 weeks while my bone heals.  I didn’t get this running, but rather twisted my ankle while in sneakers that didn’t have the proper support, and I have a very flat foot.  Initial x-rays did not show a fracture so I wasn’t put in a boot, just an air cast.  After 2 weeks I felt better and stopped using the brace.  After 2 long days on my feet with no brace (including HVTC race #1) I couldn’t walk again and went back to the podiatrist.  An MRI was ordered and low and behold I had a stress fracture, and a torn ligament in the bottom of my foot. I tore the calcaneal – navicular ligament (spring ligament), which will make my flat foot even worse, and being in custom orthotics even more important.

 

So the moral of the story is if you are a pronator and want to be the most biomechanically invincible Triathlete, get in the proper support and footwear fast. Then watch those aches and pains go away, as well as your times going down.

 

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Dr. David Ness is a certified sports chiropractor practicing in New Paltz, N.Y.  Dr. Ness is the official chiropractor and Active Release Techniques provider for the Vassar College Athletic Dept.  Dr. Ness  has worked at the Lake Placid Ironman event as part of the ART treatment team since 2004.  Dr. Ness has been the ART provider for the Hudson Valley Tri Club since 2005 years providing free ART care after club races.  Dr. Ness also provides treatment at NYTC races around the NY metro area, and continues to work as part of the SOS Triathlon post-race care team, and at American Zofingen Ultra Duathlon.

Lower Back Pain & the Triathlete

Triathlon training and racing takes its toll on the lower back.  Long hours on the bike, the pounding of the road when running. Throw into the mix on top of your training are work, and everyday life that adds on the stress and strain to the lower back and spine.

Statistics show that between 60-80% of all North Americans will suffer from lower back pain at some point in their lives.  With the number of people in the workforce in sedentary jobs where sitting is the primary posture (and we don’t use good posture when we sit), spinal muscles weaken due to lack of endurance and strength, and a failure of these muscles to maintain good posture when sitting occurs.  Over time, this puts more pressure on our spinal discs, which can cause premature degeneration of the spinal disc, and bones of the spine.  This is commonly called Osteoarthritis of the spine and results in a weakness of the core ligaments, spinal discs, and muscles of the spine, and pain.  Other consequences of sitting long hours at work or driving without frequent breaks to stretch our legs and back are tight hamstrings, calves, and tight hip flexor (Psoas) Muscles.   Other repetitive types of jobs where frequent bending, lifting, twisting are required, also cause tremendous stress on our bodies and spine and can also result in damage to our muscles, and spinal discs.  More severe disc injuries where there is swelling (bulging) of the disc, or leakage of the disc material outside of the discs (herniation) can really hamper training when symptomatic.  If you have a bulging or herniated disc the swollen disc puts pressure on the spinal nerves and can cause severe pain in the lower back and leg causing sciatica.  Some disc herniations can be so debilitating that surgery may be required to relieve the pressure on the spinal cord or nerves.

So what can you do to prevent back pain and a disc injury?  The answer simple but it requires a constant effort.  If you are in a job that requires a lot of sitting or driving, get up frequently (2 times per hour).  Stretch your hamstrings, back, and hip flexors holding each stretch for 10 seconds. Do this all day long if you can.  This will prevent further tightening of the muscles of your back, and legs.  Also, stretching prior to physical activity is recommended for 5 minutes after a brief warm up.  Exercises that strengthen your core and spine, and build endurance in these muscles can be yoga or Pilates based in addition to traditional back and abdominal workouts.  Just doing sit ups do not strengthen your core.  Prone back extensions, hip extension, superman lifts all train the backside of the body.  Abdominal workouts should focus on strengthening the oblique and transverse abdominal muscles in addition to the 6-pack rectus abdominus muscle.

How do you recognize when you have a more serious back problem versus muscular pain from a hard or long work out?  Pain that doesn’t go away within in a few days could be the sign of a more serious muscular injury, osteoarthritis, or a disc injury.  Pain that shoots down the leg from the lower back or hip is sciatica.

What else can be done to heal an injured back or prevent a back injury?  Getting the proper medical attention as soon as possible can save you a lot of training time lost down the road.  Massage therapy, chiropractic, physical therapy, and acupuncture, can help heal injured areas better than doing nothing and hoping it goes away.  If you have tried a home care program that has included stretching, strengthening, and rolling on a ball or foam roller, and still are not getting better seek out some form of treatment.  Ignoring the pain and running or biking with pain can cause the body to accommodate for pain or weakness. If you train too long with an injury you may end up injuring some other part of you that is compensating for your injury.  Then you have two injuries to deal with not one!

 

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Dr. David Ness is a certified sports chiropractor practicing in New Paltz, N.Y.  Dr. Ness is the official chiropractor and Active Release Techniques provider for the Vassar College Athletic Dept.  Dr. Ness  has worked at the Lake Placid Ironman event as part of the ART treatment team since 2004.  Dr. Ness has been the ART provider for the Hudson Valley Tri Club since 2005 years providing free ART care after club races.  Dr. Ness also provides treatment at NYTC races around the NY metro area, and continues to work as part of the SOS Triathlon post-race care team, and at American Zofingen Ultra Duathlon.

Muscle of the Month – Iliopsoas Muscle

For those of you that enjoyed last month’s featured muscle, we have the latest installment of Muscle of the Month.

The Iliopsoas muscle is often overlooked in training and in the treatment of lower back pain. In this addition of the muscle of the month we will look at ways to tell if you have a weak or shortened Iliopsoas muscle, and ways to stretch and strengthen your Iliopsoas muscle. We will also look at injuries to the psoas and their effect on the lower back and core.

The Iliopsoas muscle is actually broken into 3 muscles, the Psoas major, Psoas minor, and the Iliacus muscle. The Psoas major originates from the lumbar vertebra, lumbar discs, and transverse processes and inserts into the lesser trochanter of the Femur. The Iliacus muscle originates from the anterior fossa of the Ilium and joins with the Psoas major to form a common tendon that inserts into the lesser trochanter of the femur. Both muscles go under the inguinal ligament before inserting into the lesser trochanter of the Femur.

These muscles function with the other hip flexor muscles to flex the hip when your trunk / spine are fixed, or to flex the trunk / spine when the legs are fixed. In other words, the Iliopsoas either raises your thigh to your body, or bends your body towards your thighs.

The Iliopsoas muscle is very important in maintaining the proper lumbar lordotic curvature, and pelvic tilt in all activities. People who are in sedentary jobs, or sit or drive for long hours are prone to shortened hip flexors. Long hours training on a bicycle can also contribute to a tight Iliopsoas. If you have a shortened Iliopsoas muscle your pelvis tilts anterior, which will cause your lumbar curve to increase thus altering your spine and pelvic biomechanics. Running with this over time will increase the wear and tear on your lumbar intervertebral discs, and sacroiliac joints leading to lower back and sacroiliac pain.

To test yourself for tight Iliopsoas you have to lie on a bed or bench and take one knee into your chest. Then try to lower your opposite leg and knee off of the side of the bed. If your knee stays above or does not touch the bed you have a tight Iliopsoas muscle.

To stretch the Iliopsoas lunges with a foot on a chair and bend into the knee on the chair. This opens and stretches the opposite hip flexor. This can also be done with a knee on the floor and leaning into the bent knee opening and stretching the opposite side. For an additional stretch you can lift the arm on the side opposite of the bent knee and side bend to the side of your bent knee.

There are many ways to strengthen your Iliopsoas you can do your favorite abdominal exercises like crunches. One legged standing balance work is good for creating strength and stability in the core muscles. Dead bug exercises, (lying on your back and moving the arms and legs like a dead bug) strengthens the abdominals and Iliopsoas. 3 sets of 30 seconds or 1 minute of the dead bugs will get you in shape with a 30 second rest in between sets. Planks and bridges also will help strengthen the Iliopsoas and abdominals creating a solid core.

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Dr. David Ness is a certified sports chiropractor practicing in New Paltz, N.Y.  Dr. Ness is the official chiropractor and Active Release Techniques provider for the Vassar College Athletic Dept.  Dr. Ness  has worked at the Lake Placid Ironman event as part of the ART treatment team since 2004.  Dr. Ness has been the ART provider for the Hudson Valley Tri Club since 2005 years providing free ART care after club races.  Dr. Ness also provides treatment at NYTC races around the NY metro area, and continues to work as part of the SOS Triathlon post-race care team, and at American Zofingen Ultra Duathlon.

Bad posture alters children’s throwing bio-mechanics causing injury.

I saw another rotator cuff injury in my office recently where the childs’s slumping posture caused a bio-mechanics imbalance in the shoulder and caused an injury from the demands of pitching.  Children who have a slumping posture develope imbalances in the muscles that stabilize the scapula, rotator cuff, and spine.  This causes a decrease in the space that the rotator cuff tendons have to move in resulting in impingement.  Over time with repetitive motions and  overuse the muscles and tendons can develop micro tears causing pain, decreased range of motion, and weakness.  If a child is having continued shoulder pain and it is not recognized soon the continued use or overuse causes can cause a larger tear or other damage to the shoulder, elbow, and spine.   It is not uncommon seeing college,  high school, and even middle school athletes having shoulder and elbow injuries due to overuse, and altered biomechanics associated with bad posture.   The shame of it all is that a lot of these injuries and surgeries could be avoided and corrected if they were identified early by a sports medical professional.  Chiropractic care, Physical Therapy,  Active Release techniques, and corrective exercises can correct posture.  If your child enjoys sports but are not listening to you when you tell them to sit up straight explain to them why.   If they have the potential to use sports to get the into college or beyond explain it to them that not sitting up straight will do more than give them bad posture.  It can cause them to have pain and get injured.  Some of the injuries kids are getting can be career ending injuries and result in surgery dashing the hopes and dreams of  children and parents alike.  Dr. David Ness

Dr. David Ness is a certified sports chiropractor practicing in New Paltz and Poughkeepsie.  Dr. Ness is the official chiropractor and Active Release Techniques provider for the Vassar College Athletic Dept since 2010, and the Hudson Valley Triathlon Club since 2005.

Muscle of the Month – Multifidus Muscles

It’s June 1st, time for Muscle of the Month.

The multifidus muscles are groups of muscles that are deep and are attached to the spine. They attach from your tailbone (sacrum) at every spinal level all the way up to the top of your neck, and span 3 spinal segments per muscle. These thin muscles are mostly responsible for maintaining posture and alignment in all activities, and are considered part of the back core muscles along with the erector spinae muscles. These muscles work in concert with the other core muscles; the deep abdominal muscles, pelvic floor muscles, hip muscles, and diaphragm. Training these muscles specifically can be done with Pilate’s, Yoga, Egoscue Technique, and other methods including physio balls or stability training devices like Bosu Balls.

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Preventing Early Season Injuries; Shin Splints

So as the days get longer and warmer as spring approaches I wanted to remind everyone to take it easy as you switch to running outside.  The following are the most frequent causes of shin splints, and other types of lower extremity sprain, and strains:

  1. Running Downhill
  2. Running on a canted (slanted) surface
  3. Running in worn out footwear
  4. Running without the proper support if you’re a pronator or supinator
  5. Training too hard, too fast, too long… and too soon in the season

The signs of shin splints are tenderness; soreness, pain, and possibly swelling at the inside lower Tibia (Shin Bone).  It happens when the Tibialis Posterior muscle, and the surrounding muscles, fascia, and periosteum (covers the bone) are overloaded and then injured.

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Dealing with Handlebar Palsy.

Have you ever felt numbness, tingling or weakness in your hands when you have been riding your bike?   This common condition is an irritation of the Ulnar nerve and is called Handlebar Palsy, when it effects the Median nerve is actually Carpal Tunnel Syndrome. These nerves supply the fingers of your hand with sensation, and the muscles of the fingers and hand with strength.  Overuse from biking by using the same hand position over time, vibration from the road transmitted to the hand, and improper bike fitting, can cause a irritation or pinching of the Ulnar and Median nerves due to the compressive forces on them.  Either of these conditions affects Triathlete’s due to the amount of time spent on the bike training.  These conditions are worse in persons who spend time on computers, or work with power tools, due to underlying forearm and hand muscle overuse.  In the beginning stages the tingling or numbness goes away when you change hand positions.  Later stages of nerve inflammation and irritation can cause severe pain, and weakness of the fingers that is not relieved after changing the position of your hands, and can actually be so severe that you might not be able to bike for extended periods of time.

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Active Release Techniques and its use in sports injuries, and performance.

Active Release Techniques (ART) is a patented state of the art treatment for a wide range of soft tissue injuries, and nerve injuries.  It is used by most professional sports teams, Olympic athletes, performers, and triathletes.  It is also used to treat repetitive strain injuries like carpal tunnel syndrome, and other overuse syndromes that are not athletic injuries in nature.

ART was invented by a chiropractor in Colorado who has competed in over 35 IM events.  The technique was born out of the treatment of all the possible aches, pains, and injuries that triathletes suffer, and tested in the field at IM events.  The Timex triathlon team members use ART before most events and when they get injured.  The top triathletes in our area when they break down come in for tune ups, or a series of appointments to get them through their injuries and aches and pains from the rigors of triathlon training.  Sometimes they have tried other forms of therapy that didn’t solve the problem and have used home measures like stretching, foam rolling, and over the counter medications before coming in.

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