The Common Link in Soft Tissue Injuries

Written by: Dr. David Westmacott, B.Kin, DC, RMT

All athletes have one thing in common. Whether they have had one, are currently playing with one, or are at risk of getting one, the dreaded SPORTS INJURY is and always will be a part of sports play. Many questions arise with coaches and parents of the athlete: Is the injured athlete doing more harm by continuing to play?  When is it safe to return to play? How can the risk of injury be kept at a minimum? These questions can become a little easier to answer with a basic understanding of the physiology of the injury.

The majority of sports injuries are injuries to the body’s soft tissues. Soft tissues are muscles, tendons, and ligaments. These structures work in harmony to produce movement of the body’s frame. When a muscle or tendon is injured (strain) or a ligament is injured (sprain), the microscopic parts of these structures become deranged in such a way as to produce pain, swelling and altered function. The body begins its healing process immediately by repairing the microscopic anatomy by laying down dense, fibrotic SCAR TISSUE. Scar tissue is a gristly, glue-like substance that is resistant to stretch. The normal elasticity of the muscle, tendon or ligament is lost and pain occurs with movement.

The common link between all soft tissue injuries is SCAR TISSUE. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, thus inhibiting normal muscle function. Normal body mechanics is therefore altered predisposing the athlete to other soft tissue and joint injuries. Decreased athletic efficiency and performance is also a result of altered body mechanics.

In order for a soft tissue injury to be completely healed, the fibrotic scar must be broken down to restore the normal elasticity and pliability of the tissue. Normal functioning muscle is paramount to ensure normal body mechanics.

Active release therapy (ART) is a soft tissue treatment system that releases the scar tissue that occurs with injured and overused muscles. Back pain, shin splints, rotator cuff injuries, sciatica, plantar fasciitis, knee problems and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. The ART provider uses his or her hands to evaluate the texture, tightness and movement of muscles, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.

The key to a safe and enjoyable athletic career is a basic understanding of the physiological changes that occur with the athletic injury. An understanding of the importance to rid the body of painful, movement altering scar tissue, will not only get the athlete back on the playing field sooner but will prevent further injuries and thus increase overall athletic performance.

If you think you could benefit from an ART treatment, please contact Active Sports Therapy for an assessment from one of our chiropractors.

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.  

Staying Injury-Free during Hiking Season

Written by: Rachel Grant, MScPT, B.Kin

We are fortunate enough to live just a few short hours from the beautiful rocky mountains! Whether you are an avid hiker and have years of experience under your belt, or have just started to explore the trails, injury prevention should be a top priority. Hiking injuries tend to be injuries to the lower limb. These injuries can range from acute injuries such as a ligament sprain to overuse injuries such as tendonitis. The goal of this blog is to give you an idea of what injuries to look out for and most importantly some prevention tips.

The most common lower limb sprain injury tends to be an ankle sprain when you overstretch the ligaments in your ankle from rolling it on uneven terrain. A key aspect to preventing this injury is to first have proper footwear.

●  Getting fitted to a hiking boot or trail runner that fits you well and provides you support around the ankle joint for your activity is key.

●  Secondly, it can be beneficial to strengthen and stretch your calf muscles. Completing a basic calf stretch before and after hiking in the parking lot helps keep your ankle mobile. Strengthening your calf muscles with exercises such as a calf raise will provide stability around your ankle joint to tackle uneven rocks, tree roots and the steep incline and decline of a trail.

●  Adding in some challenging balance exercises such as balancing near a counter with your eyes closed or working on maintaining your balance while standing on a pillow can prepare your ankle for the mountains.Overuse injuries are the next most common injuries you can encounter. Pain at the front of the knee, particularly with the descent of a hike can result in injuries such as patellofemoral pain syndrome and/or patellar tendonitis (inflammation of the tendon). Stretching and strengthening the muscles surrounding the knee and hip joint can help prevent and treat this knee pain.

●  Stretching the front of the thigh of the quadriceps muscle before & after a hike is also beneficial to prevent this injury. A simple stretch you can add is shown here.

●  Strengthening this same muscle with exercises such as a single leg step up and down a stair, and lunges can also be very beneficial.

●  Strengthening your hip muscles such as your glutes will provide support to your knee joint. Simple exercises such as a squat and a glute bridge with a resistance band are a great addition to any workout program. Lastly, an important part of injury prevention is preparing your body for the activity by slowly building up your endurance. Starting with lower elevation and shorter hikes at the beginning of the season to gradually building up to more challenging trails builds up your muscles to tackle a full hiking season injury free! Don’t forget about taking adequate rest breaks during the hike and in between hiking days while mixing in other kinds of exercise such as cardiovascular and strength training.

Sadly, despite our best efforts, injuries may still happen. If you experience injury hiking or maybe you would like to focus on injury prevention tailored specifically to you, our team at Active Sports Therapy can design a treatment program for your goals today! Call the office at 403-278-1405 today to book in with our team of experts.

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.

Foot pain and the Tarsal Tunnel

Written by: Dr. Evan Steinke, B.Sc, DC


Your foot and ankle are hosts to a considerable number of arteries, tendons, and nerves. These structures have weaved in and around bones with very limited space. In the case of Tarsal Tunnel Syndrome (TTS) they pass through a rather small tunnel where they have the potential to be compressed. As a result, patients may suffer from pain at and below the point of compression. This leads to the characterized pain along the inner ankle and sole of the foot possibly with numbness or tingling. In some cases, it may feel like a burning sensation and be
accompanied by weakness of the foot muscles.

The tarsal tunnel itself is comprised of two main structures, the base and the roof. The base of the tunnel is created by a concave in the bones of the feet with one peak being the ankle and the other being the innermost part of the heel. The second structure is a fibrous connective tissue running between the two peaks essentially acting as a roof and creating the tunnel. The tunnel is filled by three tendons, an artery and vein, and the tibial nerve. Due to the high number of structures running through a closed, narrow space any amount of swelling or inflammation can lead to compression of the tibial nerve. It is this compression that causes the symptoms of
TTS such as the pain and tingling sensation.


Treatment is based on trying to relieve pressure on the tibial nerve as it enters and passes through the tarsal tunnel. This often includes trying to reduce swelling and inflammation of surrounding tissue or injuries, especially to any tendons that directly pass through the tunnel itself. This may include icing or resting protocols or over-the-counter anti-inflammatories. Adjustments to the base of the tunnel may be performed if there are any bony malalignments. Additionally, soft tissue massage or ART/MRT may be applied to tight muscles to try and alleviate pressure from the nerve.

If you are interested in a more in-depth explanation of the lower leg and ankle you can learn more in an upcoming webinar hosted by Dr. Evan Steinke on December 15 at 7:00 PM. Sign up here.

If you are looking to book a personal assessment to get to the source of your hip pain book in at either AST location. Our many expert practitioners will assist you in your journey toward better hip mobility. If you are looking to book in with Dr. Evan Steinke, he works at AST Westman.

*The content contained in this blog is provided for general information purposes only. The above content is general suggestions and not intended to replace the services of a trained physician, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment. 

Knee pain and Chondromalacia

Written by: Dr Evan Steinke, BSc, DC

Pain in and around the knee is a common occurrence but the causes can be broad and varied. Chondromalacia patella, sometimes known as a runner’s knee, is one potential cause of knee pain. It is characterized by pain to the front of the knee over and around the patella, or knee cap. It may increase with prolonged sitting with knees bent such as while watching a movie. It may also increase with running and other sports that apply pressure to the knee.

Chondromalacia might sound like a mouthful but very accurately describes the condition itself. The word is derived from the word chondros, meaning cartilage, and malakia, meaning softening, hence the softening and erosion of the cartilage on the kneecap is the source of pain in this condition. As the cartilage breaks down the kneecap no longer glides as easily over the knee and may even rub against the opposing joint surface. This can result in painful irritation and irregular movement of the kneecap overtop of the femur.

Treatment of chondromalacia patella often includes trying to reduce inflammation which may be done through rest and ice. If there is a specific cause of the condition, such as running, it should also be addressed with your clinician. This could include analyzing gait, correcting muscle imbalances, using orthotics or different types of shoes, and adjusting any misalignments in the joint.

If you are having knee pain and think you may have chondromalacia it is best to see a chiropractor or physio to have it evaluated. This way an individualized treatment and management plan that addresses your needs and concerns can be created.

If you would like an assessment book in at Active Sports Therapy, for a personal assessment and treatment plan. Dr. Evan Steinke, BSc. DC works at AST Westman

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.

Knee Pain

What is a Ganglion Cyst?

Written By: Dr. Evan Steinke, DC

Wrist pain is a common occurrence whether from computer use or a sporting injury. In some cases this can be caused by a ganglion cyst which may or may not appear as a visible bump or mass over the affected joint. While it is possible to form a ganglion cyst over most joints, approximately 90% are found on the wrist and are three times more common in women than men. Due to the nature of being fluid filled the cyst is often soft rather than hard and firm. You may also have noticed this mass but have no wrist pain, that is okay, it is not uncommon for ganglion cysts to be asymptomatic as well.

In a typical healthy joint you would expect there to be a capsule surrounding the joint that is then filled with a lubricating liquid that helps the joint move smoothly. Currently, it is thought that ganglion cysts are caused by repetitive and chronic trauma to the capsule around a joint that leads to deterioration and tears. Eventually a tear produces a pouch that is filled with joint fluid resulting in a cyst. Depending on the size of the pouch this may or may not be visible over the wrist. For this reason athletes with high wrist use, such as gymnasts, are prone to this condition.

Examination by your chiropractor can help evaluate and rule out other possible causes of wrist pain. It may be necessary to get imaging, such as xray, to rule out other severe causes of wrist pain.

Treatment of ganglion cysts will vary depending on symptoms. Even in cases where it is asymptomatic you should still have an evaluation to rule out other possible causes. The ganglion cyst may regress by itself, however, in the cases of wrist pain a conservative care approach can be offered. This may include modifying activities, adjusting ergonomics, splinting and more. It is not recommended to try and pop or drain the cyst yourself. 

In cases with pain, nerve symptoms or for cosmetic appearance you may be a candidate for an aspiration of the cyst. This is a minimally invasive technique where a needle is inserted and the excess fluid is drained. It should be noted that there is a chance of recurrence. In these cases surgery may be performed to remove the pouch which has a much lower chance of recurrence.

If you are experiencing any of the above symptoms be sure to book in at Active Sports Therapy, for a personal assessment and treatment plan. Dr. Evan Steinke, BSc. DC works at AST Westman

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.

Carpal Tunnel or Pronator Teres Syndrome?

Written By: Dr. Evan Steinke, B.Sc., DC

Carpal tunnel syndrome (CTS) is a well-known condition that can cause wrist and hand pain. It is notorious for causing pain and/or numbness along with the hand among office workers, gardeners, and anyone performing repetitive tasks. It is caused by the squeezing of the median nerve as it passes through a narrow tunnel at the wrist. However, despite how prevalent CTS is it is not the only location the median nerve can become compressed.

Pronator Teres Syndrome (PTS) is a lesser-known form of median nerve compression and may mimic, and even be misdiagnosed, as CTS. The condition is named after the muscle that causes it, the pronator teres. This is a relatively small forearm muscle located at the inner elbow and is responsible for turning our forearm palm side up (known as pronation). What makes this muscle interesting is that in most people there are two heads to the muscle and the median nerve passes directly between the two. As a result, muscle tension or injury can lead to compression of the median nerve. Compression at the elbow will result in downstream effects such as pain, pins and needles sensation, numbness or muscle weakness in the hand, again mimicking the effects of CTS. Interestingly, around 1 in 7 people are missing the second head of the pronator teres muscle which is thought to reduce the risk of developing this condition.

Patients suffering from PTS may have increased forearm irritation when activating the pronator muscle and may also experience upper forearm pain. However, differentiating the conditions can be nuanced so checking with your doctor and having a detailed physical exam can help differentiate the two. While a physical exam is often sufficient in severe cases your doctor may recommend that additional nerve tests be ordered.

Management of PTS often includes the following:

Muscle release techniques: These techniques aim to help ease pain and release muscle tension to free up the median nerve.

Exercises and Stretches: A variety of programs can be performed at home that aim to improve flexibility and decrease muscle tension.

Activity Modification: Depending on your occupation and home needs your doctor may modify your daily routines and activities to reduce the use and stress on the pronator teres muscle.

Rest: Inflammation and swelling around an injured muscle can add pressure to the nerve. Allowing the muscle to rest and the body to clear the inflammation will aid in recovery.

Ice/heat: In cases of trauma or acute injury, the use of ice and/or heat can help reduce pain and bring blood to the area.

Ultimately both CTS and PTS are caused by the compression of the median nerve just at different locations. A thorough examination is vital in differentiating the two conditions and for appropriate treatment to be applied.

If you are experiencing any of the above symptoms be sure to book in at Active Sports Therapy, for a personal assessment and treatment plan. Dr. Evan Steinke, BSc. DC works at AST Westman

Frozen Shoulder Explained

Written By: Dr Evan Steinke, DC

Frozen shoulder, also known as adhesive capsulitis, is characterized by pain and a progressive loss of motion in your shoulder joint. You may have experienced this as beginning with shoulder pain from an unknown cause that made your sleep difficult and became increasingly painful over the coming weeks. Frozen shoulder is caused by inflammation of the shoulder joint resulting in adhesions and stiffening of the surrounding structures. As a result, the shoulder begins to become painful and lose its mobility. This is more commonly seen in people over the age of 40 and is slightly more common among women with both diabetes and thyroid disease being known risk factors.

Frozen shoulder is known to have a particularly long recovery time without treatment of 18-24 months. Due to the long duration of the condition is often divided into three phases.

Phase 1 – Freezing: Pain in the shoulder as it begins to tighten over several months. It may be particularly noticeable at night and progress to being painful at rest.

Phase 2 – Frozen: The structures around the shoulder are now adhered to each other and mobility is limited in most or all directions, however, pain may begin to diminish in this phase. This phase can last for up to a year.

Phase 3 – Thawing: The structures around the shoulder begin to loosen and allow for a gradual return of shoulder mobility over 6+ months.

Your doctor will be able to determine which phase you are in with a physical examination, there is no need for x-rays or other forms of imaging. Management of frozen shoulder depends on the phase you are currently in but will often include a wide range of physical therapy approaches aiming to improve your range of motion and providing relief. These can include the following:

Muscle release techniques: These techniques aim to help ease pain in the surrounding shoulder muscles and reduce muscle tension to allow for improved movement.

Exercises and Stretches: A variety of programs can be performed at home that aim to improve muscle strength, improve flexibility, and provide improved joint stability.

Mobilization: Working with the shoulder joint directly your therapist will help mobilize the joint to improve range of motion.

Activity Modification: Depending on your specific needs your doctor may also make modifications to your daily routines and activities to ease the load and stress on your shoulder joint.

In severe cases that do not respond to conservative care your therapist will be able to evaluate and direct you for a shoulder injection or discuss other options for your particular situation.

If any of these symptoms sound familiar call Active Sports Therapy at 4032781405 to book your shoulder assessment today.

Active Release Techniques - A Very Successful Type of Hands-On Treatment

By: Active Sports Therapy

ART stands for Active Release Techniques.  It is a highly successful hands-on treatment method that addresses problems in the soft tissues of the body, including the muscles, ligaments, fascia, and nerves.  ART treatment has great success in dealing with soft tissue injuries because it is specifically designed to locate and treat scar tissue adhesions that accumulate in the muscles and surrounding soft tissues.

You can think of an ART treatment as a type of active massage. The practitioner will first shorten the muscle, tendon, or ligament, and then apply a very specific pressure with their hand as you actively stretch and lengthen the tissues.  As the tissue lengthens the practitioner is able to assess the texture and tension of the muscle to determine if the tissue is healthy or contains scar tissue that needs further treatment. When scar tissue adhesions are felt the amount and direction of tension can be modified to treat the problematic area. In this sense, each treatment is also an assessment of the health of the area as we are able to feel specifically where the problem is occurring.

An additional benefit of ART is it allows us to further assess and correct problems not only at the site of pain itself, but also in other areas of the kinetic chain, which are associated with movement compensations and are often contributing factors to the problem. This ensures that all the soft tissues that have become dysfunctional and are contributing to the specific injury are addressed, even if they have not yet all developed pain.

One of the best things about ART is how fast it can get results. In our experience, there are many types of injuries that respond very well to ART treatment, especially when combined with the appropriate home stretching and strengthening exercises. Although each case is unique and there are several factors that will determine the length of time required to fully resolve each condition, we usually find a significant improvement can be gained in just 4-6 treatments.

Here’s a list of common problems that our chiropractors are equipped to treat using Active Release Techniques. You may be surprised to learn that our chiropractors can treat more than just your back!

Achilles Tendonitis, Ankle Injuries,Back Pain / Injuries, Bicipital Tendonitis, Bursitis. Carpal Tunnel Syndrome, Compartment Syndrome, Foot Pain and Injury, Frozen Shoulder, Gait Imbalances, Golf Injuries, Golfer’s Elbow (Tendonitis), Hand Injuries, Headaches, Hip Pain, Hyperflexion Injuries, Iliotibial Band Syndrome, Impingement Syndrome, Joint Dysfunction, Knee and Leg Pain, Knee Meniscal Injuries, Muscle Pulls or Strains, Muscle Weakness, Myofascitis, Neck Pain, Nerve Entrapment, Syndromes, Repetitive Strain Injuries, Plantar Fasciitis, Post – Surgical, Restrictions, Running Injuries, Rib Pain, Rotator Cuff Syndrome, Shin Splints, Scar Tissue Formation, Sciatica, Swimmer’s Shoulder, Shoulder Pain, Sports Injuries, Thoracic Outlet Syndrome, Tendonitis / Tendonosis, Tennis Elbow,Weight Lifting Injuries, Throwing Injuries, TMJ, Whiplash.

Book an appointment today with one of our ART trained Chiropractors. 

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.  

Shockwave Therapy - For Fast Pain Relief and Mobility Restoration

Active Sports Therapy is excited to introduce Shockwave therapy. Shockwave has proven to be helpful for many chronic conditions.

Who can benefit from Shockwave therapy?

Patients with chronic pain who have been treated unsuccessfully with other forms of therapy may benefit from Shockwave. Conditions such as shoulder pain, tennis elbow, heel spurs, hip pain, knee pain, carpal tunnel syndrome, calcification, or chronic tendinopathy treated by Shockwave have reported up to an 80% success rate.

What is Shockwave Therapy?

Shockwave therapy produces acoustic waves with high energy peaks that interact with tissue, causing effects such as accelerated tissue repair and cell growth, analgesia or pain relief, and mobility restoration. New blood vessel formation is caused by the therapy through creating capillary micro-ruptures in tendon and bone, thus triggering repair processes. With Shockwave therapy, reversal of chronic inflammation, stimulation of collagen production and the breaking up of calcium build up can be achieved.

Shockwave Therapy FAQ's

Does the treatment hurt?

There might be a slight feeling of discomfort during the treatment, however, treatments are short and last only about five minutes. As well, the intensity of the Shockwave can be adjusted to make the patient more comfortable.

How many treatments will I need?

The number of treatments will vary depending on each person, but the effects of each treatment are cumulative. Most people will not need more that 4-6 treatments per area. Many people will notice an improvement after their first treatment.

How often will the treatments occur?

Most patients will be treated 1 to 2 times per week depending on their response to the treatment and their tolerance for the treatment.

Will there be additional pain after a treatment?

Most patients experience immediate pain relief following a treatment, however within 2-4 hours after the treatment, there may be some soreness in the area.

Are there any restrictions after treatment?

It is recommended that a patient refrain from physical activity, particularly any activity that would heavily rely upon the treated area for 48 hours post each treatment.

Please give us a call at 403-278-1405 or email us at mail@activesportstherapy.ca to book a consult or treatment.

References: BTL's Shockwave Therapy Complete Edition

Carpal Tunnel Syndrome and Treatments

By: Dr. Corey Finan BSc., DC, CCSP, RMT, ART

Carpal Tunnel Syndrome (CTS) is a condition in which the patient feels pain, numbness, tingling and other symptoms that can be uncomfortable or painful in the hand and arm. It is caused by the compression of the nerve in the carpal tunnel, hence it’s name. The carpal tunnel is a narrow passageway on the palm side of the wrist. The issue is related to the median nerve which goes from your forearm and through the carpal tunnel passageway to your hand. It is responsible for sensation in your hands as well as muscle function. When this nerve is irritated, or the passageway is narrowed, then we feel the symptoms of Carpal Tunnel Syndrome.

Causes can range from arthritis and inflammation, workplace factors such as computer work and working with tools where repetitive motion is required. Obesity is a risk factor, and females tend to suffer from this condition more often than men.

Carpal Tunnel Syndrome will usually start off progressing in a gradual way. The most common symptoms include the following:

Tingling and Numbness – this could be in your hand or in your fingers and is often felt in the thumb, index, middle or ring fingers. The sensation may travel from the wrist and even into the arm. You may feel these sensations when the hands are outstretched doing something such as holding a newspaper or book, or a smart phone.

Weakness – You may feel like your hands are weaker than usual. This could be due to the numbness and the issues that are happening in the median nerve.

Preventative Measures:

Other Things to Consider: 

Carpal Tunnel Syndrome can occur in anyone, but there are some things that you may want to look at first before thinking you have CTS.  First, there is a much more common cause for numbness and pain in the hand / fingers, and that is Cubital Tunnel Syndrome, which is a nerve entrapment in the elbow where the nerves enter the forearm.  Often repetitive strain at the hand and wrist can cause the muscles in the forearm and elbow to become tight, and thus compress the nerves to your hand.  Another important caveat would be to consider whether conservative care would be a better alternative for you, or if surgery may be the way to go. A trial of conservative care, specifically Active Release Therapy (ART), may prevent the need for surgery.  You can easily determine that by doing a Diagnostic Ultrasound of the Median Nerve at the Carpal Tunnel.  If the nerve is enlarged, you can be certain that it is inflamed at the tunnel.  This would indicate that the decompression surgery typical of CTS surgery would be of benefit to you.  However, if the nerve is of normal size, then you should not do the surgery, and seek conservative care and look elsewhere in the body for the problem.  These are simple guidelines that can help you determine which direction to go.  All of the Doctors at AST can order the Diagnostic Ultrasound imaging and can interpret the results and give guidance as needed.

Treatment From Our Clinic

If you think you may be suffering from Carpal Tunnel Syndrome, our clinic has several treatments that might benefit you. Active Release Techniques for one can be very helpful to treat this syndrome. The practitioner will evaluate your mobility and tightness of the area which will usually be due to the presence of scar tissue. By using manual pressure, the practitioner can break up the scar tissue to lessen the pressure on the median nerve, resulting in a reduction in symptoms. Many people can find relief in just a few treatments!  There are several forearm muscle stretches and exercises that we can teach you to help remove some of the symptoms, and more importantly keep them at bay once you improve.  We also provide IMS which can help with pain relief in the forearm muscles, and Graston Technique which is an instrument assisted soft tissue treatment designed to help break down scar tissue and release tight muscles.  Shockwave Therapy and Laser Therapy can also be additional therapies that can speed recovery.  We have seen hundreds of cases of Carpal Tunnel Syndrome over the years with most resolving successfully in a relatively short period of time.

If you believe that you might be suffering from Carpal Tunnel Syndrome, please give us call to book your appointment.

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.