Athlete’s Shoulder

Athlete’s Shoulder - Resolving Shoulder Injuries with Active Release Techniques (ART)

By: Dr. David Westmacott

Athletic activities require a considerable amount of strength, coordination, and flexibility from the shoulder.  As a result, athletes participating in sports such as swimming, paddling, golf, baseball, and tennis, commonly develop shoulder injuries.  Unfortunately, when shoulder injuries occur they not only prevent optimal performance, but they often progress to the point of preventing competition and training altogether.  To make matters worse, many of the most common shoulder conditions are slow to respond to traditional types of treatment and often result in months of frustration for the athlete.

Fortunately, a new treatment technique known as Active Release Technique (ART) is proving to be a very successful method to combat many common shoulder problems and get athletes back in the game quickly and effectively.  But before we talk about why ART works so effectively, first we need to understand how the shoulder becomes injured in the first place.

Shoulder Basics – The high cost of mobility

The shoulder joint consists of the round head of the upper arm connecting to the flat surface of the shoulder blade.  This “round-on-flat” relationship is different from most other joints in the body, and as a result is capable of providing a great deal of movement.  For example, most joints allow only one direction of movements (i.e. ankle, knee, elbow, fingers).  In comparison, the architecture of the shoulder allows us to reach up overhead, back behind the body, across the chest, and into internal and external rotation.

Over time the muscles become strained and develop small scale injury known as micro-trauma.  Initially this micro-trauma is not painful, but may be perceived as a mild ache or tightness in the muscles.  Although only small, the damage still needs to be repaired.  The body responds to tissue injury in a very predictable way – by laying down new tissue to repair the damaged tissue.  With micro-trauma the body repairs the strained tissue by laying down small amounts of scar tissue in and around the injured area.  The scar tissue itself is not a problem – in fact it is a normal and necessary part of healing.

The problem occurs when the shoulder is repeatedly subjected to the same high force athletic movements.  This in turn causes the same muscles to become strained and subsequently repaired over and over again.  Over time scar tissue will build-up and accumulate into what we called adhesions.  As these adhesions form they start to affect the normal health and function of the muscles.  In fact, they will often lead to pain, tightness, stiffness, restricted joint motion, and diminished blood flow.

As these scar tissue adhesions accumulate in the shoulder region, it places more and more strain on the muscles as they must now stretch and contract against these adhesions in an attempt to move and stabilize the shoulder.  This places even further strain on the shoulder muscles, which in turn leads to more micro-trauma.  Essentially a repetitive injury cycle is set-up causing continued adhesion formation and progressive shoulder dysfunction.

As the cycle progresses the ability of the muscles to contract properly is affected and the stability of the shoulder becomes compromised.  At this point it is not uncommon for the muscles to give way, resulting in a more severe and debilitating pain.  In fact, many athletes come into our office explaining how they have hurt their shoulder during a routine task that they have done thousands of times before.  When further questioned these athletes almost always describe some mild pain or tightness in their shoulders that has been building over time.  As you can see from the explanation of the repetitive injury cycle, these types of injuries build-up over time and the more acute injury is often just the “straw-that-broke-the-camels-back”.

How are Shoulder Injuries Best Treated?

The Traditional Approach

In the attempt to relieve shoulder, a variety of treatment methods are used, either on their own, or in combination with other methods.  Some of the more common approaches include anti-inflammatory medications, rest, ice, ultrasounds (US), muscle stimulation (E-Stim), steroid injections,  stretching, exercise, and when all else fails, surgery.  Unfortunately, most of these traditional techniques generally require a long period of time before they provide any significant relief, and in many cases, provide only temporary relief from symptoms instead of fixing the underlying cause of the problem.  This can be a huge problem as athletes often want and need to get back to training and competition as soon as possible.

The main reason these traditional approaches are often ineffective is they fail to address the underlying scar tissue adhesions that develop within the muscles and surrounding soft tissues.  It is these adhesions that are binding the tissues together, restricting the normal movements, and interfering with the normal flexibility, and contraction of the muscles in the shoulder area.

Passive approaches, such as medications, rest, ice and steroid injections, all focus on symptomatic relief and do nothing to address the muscle restrictions and dysfunction.  More active approaches, such as stretching and exercises, are often needed for full rehabilitation of the condition and to restore full strength and function of the muscles, however, they themselves do not treat the underlying adhesions.  In fact, without first addressing the scar tissue adhesions, stretches and exercises are often less effective and much slower to produce relief or recovery from the shoulder condition.

One of the best things about ART is how fast it can get results.  In our experience, the majority of shoulder injuries 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.  These results are the main reason that many elite athletes and professional sports teams have ART practitioners on staff, and why ART is an integral part of the Ironman triathlon series.

To book an appointment to see if ART will be able to help with your elbow injury, simply call our office at 403-278-1405.

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.  

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 Injuries & Skiing

Written By: Rachel Grant, MScPT, B.Kin,

It’s that time of year again and whether it's your first time clipping into your bindings or you are a seasoned skier, prevention of knee injuries should be at the top of your mind.

The knee joint is composed of bones, cartilage, ligaments and tendons. The most common knee injuries related to skiing include damage to the ligaments; a ligament is a short band of tough fibrous tissue that connects bone to bone. Meniscus or cartilage injuries within the knee itself are the second most most common injuries. The four primary ligaments in your knee hold the bones together to help stabilize your knee. The knee can become easily injured because it relies heavily on the ligaments, meniscus, cartilage and the surrounding musculature for stability.

Skiing is a sport that tests the ligaments and supporting structures in the knee through quick changes of direction and constant muscle contraction to maneuver down snow or ice. Strength training and targeting every muscle group of the lower limb is one way to set yourself up for a successful ski season!

Below are some examples of each lower limb area to focus on, along with an exercise example:

Hamstrings:

-Bridges, single leg bridges, Nordic curls

Quads:

-a combo of closed chain exercises where both legs are on the ground such as squats, along with open chain exercises like controlled step downs and lunges.

Hip Strengthening for Gluteus Medius and Maximus:

-Clamshells, side lying hip abduction, single leg squats

Other Important Knee Injury Prevention Tips:

-Learn proper technique with a professional if you are new to the sport

-Choose suitable runs (green, blue, black) comparable to your ability level.

-Ensure you have properly fitted equipment. Including ski's bindings, and poles. Most importantly, check your bindings are fitted to the boot you will be wearing. Non-release of bindings has been reported to be a contributor of skiing injuries in youths and adults. Release bindings which can be adjusted to a skiers ability and weight can help to prevent knee injuries.

-Lastly, add dynamic stretching to your ski routine. Warm up and general movement with short hold stretching (10-15 seconds) pre-skiing, such as when you are gearing up in the parking lot gets your muscles ready for the day. Finishing the day are-ski with static stretching will prevent possible injuries the following day.

Sadly, despite our best efforts, injuries may still happen. If you experience an injury skiing or maybe you want to ensure you are strong leading into the ski season, our team at Active Sports Therapy can design a treatment program for your specific 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.

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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

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.  

The Top 4 Most Common Golf Injuries

By: Active Sports Therapy

As golfing is a seasonal sport, people often jump into it quickly and with high frequency. Since 18 holes are the most common way to play, overuse injuries can occur. If you develop an injury, it can result in a frustrating experience out on the links as injuries affect your swing, and ultimately, your game.

The most common injuries include:

Golfers Elbow - Will cause pain and inflammation in the tendons that connect the forearm to the elbow. The pain may radiate into the forearm.

Wrist Pain - Can occur and is usually related to the wrist flexor or extensor tendons. Impingement syndrome and tendonitis can also occur.

Shoulder Pain – The lead shoulder is most often the one to be injured in a golfer with the rotator cuff is the most likely to become injured and it is often related to the style and form of the golfer's backswing.

Back Pain- In the upper, mid, or most commonly, the lower back can occur. Golf involves twisting, bending, and reaching down to get the ball out of the cup, all of which can add up to back pain for some.

Tips for Prevention

Swing Mechanics. Even the best golfers are taking 70-90 swings and putts per game. Considering that you can see how easily an overuse injury can occur. Learning proper posture from a golf pro might give you the corrections you need to prevent injury.

Avoid trying to hit the ball too hard. This is common for ‘new golfers’ as they opt for power over the form. Again, a lesson or two might teach you the proper pace required for a mechanically correct swing.

Be sure to use proper mechanics when lifting or carrying your bag, even if it’s just taking them out of the trunk of your car.

Just because golf isn’t a fast, contact sport, it doesn’t mean that you don’t have to stretch it out a bit before you play. Stretch your shoulders, chest, triceps, back, and lower body.

Here is a great resource from Golf Digest

How Can your Chiropractor Help with These Injuries?

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

By locating and treating the soft-tissue adhesions with ART, it allows the practitioner to, 1) break up restrictive adhesions, 2) reinstate normal tissue flexibility and movement, and 3) more completely restore flexibility, balance, and stability to the injured area and the entire kinetic chain.

This style of treatment can be applied to all of your common golf injuries. We can also help you to learn how to prevent further damage through exercises and stretches. Our physiotherapy area has specialized equipment to help speed healing with laser therapy and Game Ready ice machines. We can assign the proper stabilizing brace or suggest supplements if needed.

Book in today at www.activesportstherapy.ca and we’ll help you Get Back to Your Game!

Golf

What Injuries can be Treated with Active Release Techniques?

[vc_row][vc_column width="1/1"][vc_column_text]ART stands for Active Release Techniques.  It is a new and highly successful hands-on treatment method to address problems in the soft tissues of the body, including the muscles, ligaments, fascia, and nerves.  ART treatment is highly successful in dealing with neck injuries because it is specifically designed to locate and treat scar tissue adhesions that accumulate in the muscles and surrounding soft tissues.  By locating and treating the soft-tissue adhesions with ART, it allows the practitioner to, 1) breakup restrictive adhesions, 2) reinstate normal tissue flexibility and movement, and 3) more completely restore flexibility, balance, and stability to the injured area and to the entire kinetic chain.

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.

To book an appointment to see if ART will be able to help with your injury, simply call our office at 403-278-1405[/vc_column_text][/vc_column][/vc_row]