Articles

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.

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.

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.

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.