What Is Arthritis?

Written By: Dr Evan Steinke, Bkin, DC

Arthritis is often talked about when we discuss joint pain and stiffness but there are so many different kinds that it becomes overwhelming to know what it is and if it applies to you. The word arthritis comes from, “arthro” meaning joint, and “itis” meaning inflammation, so in the most broad sense arthritis is inflammation of joints. The inflammation of these joints leads to a host of symptoms including pain, stiffness and swelling and may range from mild to severe in intensity. While anyone can develop arthritis, including children, it is most common in older adults.

There are many different types of arthritis but two of the most common forms are osteoarthritis (OA) and rheumatoid arthritis (RA). While they both affect the joints, they’re quite different in terms of cause, progression, and treatment.

Osteoarthritis (OA):

Osteoarthritis is the most common type of arthritis and usually develops slowly over time, nicknamed the “wear and tear” arthritis. OA occurs overtime when the cartilage in joints breaks down and no longer supplies a cushion between the two bony surfaces of a joint. Without that buffer, bones can rub against each other, leading to pain, swelling, and reduced motion. It is important to note that OA is due to the mechanical wearing down of a joint over time. The body has limited ability to restore these joint surfaces and treatment provided often looks to minimize progression and strengthen affected areas. Treatment could include active release technique on surrounding muscles, chiropractic manipulation of the affected joint, and joint rehabilitation and strengthening.

Key Features of OA:

Cause: Aging, repetitive stress, joint injury, or obesity.
Who’s affected: More common in older adults
Symptoms: Joint stiffness and pain (especially in the morning or after inactivity), and reduced flexibility. Stiffness and/or pain tends to lessen with activity.
Commonly affected joints: Knees, hips, hands, and spine.

Rheumatoid Arthritis (RA):

Rheumatoid arthritis is not due to mechanical wearing down of the joint but rather is when your own immune system attacks the joint. The exact reason for why the immune system begins to attack your own joints is not fully understood. However, once the immune system begins to attack the joints it causes damage which in turn leads to swelling, pain, and stiffness. In general RA tends to attack the joints symmetrically, meaning you may see it in both hands, both knees, etc. Additionally, RA can affect more than joints including your skin, eyes, lung, heart and other organs. Treatment for this form of arthritis will often include being referred to your family physician for medications that target the inflammation and immune system to limit further damage to the joints. Physical therapies may also show benefits depending on the severity and progression of the arthritis. If you are unsure of where to start, checking in with your chiropractor will help get you the correct diagnosis and any referrals that may be necessary.

Key Features of RA:

Cause: Involves immune system dysfunction. Genetics factors are involved.
Who’s affected: Often begins between ages 25 and 50; more common in women.
Symptoms: Joint pain, swelling, and stiffness, fatigue, and even fever.
Commonly affected joints: Often symmetrical—both wrists, both knees, etc.
Treatment: Includes disease-modifying antirheumatic drugs (DMARDs), biologics, corticosteroids, and physical therapy.

Conclusion

Arthritis can affect people in many different ways, and understanding the type you are dealing with is key to finding the right treatment approach. Whether it's the wear and tear of osteoarthritis or the immune system involvement of rheumatoid arthritis, getting the right diagnosis and care early on can make a big difference in your long-term joint health and quality of life.

If you're experiencing joint pain, stiffness, or simply have questions about your joint health, our Unified Team of Experts are to help. You can find Dr. Steinke at AST Westman — contact the clinic today to book your appointment and start your journey toward feeling your best.

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 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.

Chiropractic Care: Separating Fact from Fiction

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

Chiropractic care is a diverse health practice that has been around since the 1890’s. Since its founding it has been under intense scrutiny and the subject of many misconceptions. This can lead to confusion, misinformation, and make new patients unsure of where to begin. So, let’s discuss the big three myths about chiropractic care and the actual research that debunks them.

Myth 1: Chiropractic manipulations are dangerous

There is a common misconception that chiropractic care, particularly the chiropractic
manipulation, is dangerous. Over the years there has been an increasingly large pile of
evidence to state that spinal manipulations are safe and effective. In the case of chronic lower back pain, which is the leading cause of disability globally, the World Health Organization released guidelines in 2023 that recommended treatment with spinal manipulative therapy. Additional research has repeatedly shown that spinal manipulations are safe and do not impose an increased risk of mild or moderate adverse effects (1). In a separate study investigating stroke risk with chiropractic visits compared to primary care, they found there was no evidence of excess risk associated with chiropractic care compared to primary care (2).

World Health Organization Report: https://www.who.int/publications
Alberta Health: https://myhealth.alberta.ca/Health/

1) Pankrath, Natalie et al. “Adverse Events After Cervical Spinal Manipulation - A
Systematic Review and Meta-Analysis of Randomized Clinical Trials.” Pain
physician vol. 27,4 (2024): 185-201.
2) Cassidy, J David et al. “Risk of vertebrobasilar stroke and chiropractic care:
results of a population-based case-control and case-crossover study.” Spine vol.
33,4 Suppl (2008): S176-83. doi:10.1097/BRS.0b013e3181644600

Myth 2: Chiropractors are not considered doctors

Most often people are familiar with MD’s or Medical Doctors such as their family physician, however, other doctors have different abbreviations. In the case of chiropractors, their title is Doctor of Chiropractic, and their abbreviation is DC. Most chiropractors begin with a four-year undergraduate degree often with courses including biology, chemistry, physics, anatomy and more. From there they can apply to a chiropractic graduate program which on average is an additional four years of education covering topics from rehabilitation, neurology, and biomechanics to name a few.

Additionally, significant time is spent on the development and training of manual adjustment techniques. From there graduates undergo an additional layer of testing to become certified in their province or state which includes both written and in-person skill examinations. In Alberta, these certification requirements are enforced by the College of Chiropractors of Alberta, which also requires additional training to be performed every year to keep chiropractors current and up to date.

Source: https://www.theccoa.ca

Myth 3: Chiropractors only treat the spine

Chiropractors are perhaps best known for their treatment of the spine and are most often sought out for low back pain. However, chiropractors are trained in all areas of the body and are considered muscle, nerve, and bone specialists. Additionally, manipulations can be provided for more than the spine and can include the hips, knees, wrist, ankle and more. Therefore, if you’re experiencing anything from carpal tunnel syndrome to jaw pain you can ask your chiropractor for advice and treatment!

In conclusion, understanding the facts about chiropractic care can empower you to make informed decisions about your health. If you're seeking professional support, we invite you to experience the expertise of Active Sports Therapy's chiropractors.

At AST our Unified Team is dedicated to providing safe, effective treatment tailored to your individual needs, whether you're dealing with spinal issues or other musculoskeletal concerns.

Don't let myths hold you back—schedule a today and discover how chiropractic care can enhance your well-being!

You can find Dr Evan Steinke at AST Westman Village.

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.

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.

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

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

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.