Are You Overstriding?

 

Here’s our latest gait analysis showing an overstriding foot strike. Interestingly, this runner only overstrides with his left leg which is the side of most of his injuries. Luckily we caught this biomechanical deficiency and corrected it pretty quickly. To fix an overstriding gait, we monitor and tweak cadence (amount of steps per minute) and start with drills to practice proper foot placement. Overstriding or improper foot placement can create some of the very common running injuries such as foot pain, knee pain, and hip pain.

What is EPAT?

EPAT photo

EPAT (extracorporeal pulse activation technology) is a type of treatment that I’m extremely excited to be adding to our practice. Before this past Christmas I received a phone call from my great friend and colleague, Dr. Brad Wiest. Dr. Wiest helps run the Carolina Sports Clinic in Charlotte, NC and is an official chiropractor of the NFL’s Carolina Panthers. During the phone call, Brad mentioned to me a new type of treatment they had started administering in their clinic. He said with this new type of treatment, they were seeing much quicker recovery rates with certain soft tissue injuries and that I needed to give it a try. I listened, tested the treatment on 16 of the most difficult injuries I’d been seeing in my office, and after very good success decided to add it to our treatment arsenal. So far, we’ve had plantar fasciitis, achilles tendinopathy, knee pain, shoulder pain, calf pain, hamstring pain, and back pain  all respond extremely well. We are proud to be the only facility in Kentucky to offer this type of treatment. A bit more about EPAT:

EPAT Therapy FAQ’s

What is EPAT?

EPAT is an acronym for Extracorporeal Pulse Activation Technology. It is a highly effective, non-invasive, office based treatment that accelerates healing of injured tissues. EPAT has a proven success rate equal to or better than other treatment methods, including surgery, without the risks or long recovery. It is performed in your physician’s office without the need for anesthesia.

How does EPAT work?

EPAT utilizes a unique set of acoustic pressure waves delivered through a special applicator focused on the site of pain or injury. These pressure waves stimulate the metabolism, enhance blood circulation, and accelerate the natural healing process.

Is EPAT safe?

EPAT is a safe, FDA approved treatment with virtually no side effects. It has been used to relieve the pain of millions of patients worldwide.

What conditions can be treated with EPAT?

EPAT can be used to treat many painful soft tissue injuries. Including: plantar fasciitis, Achilles tendonitis, tennis elbow, golfer’s elbow, patellar tendinitis, quadriceps tendinitis, tendon insertional pain, acute and chronic muscle pain, and myofascial trigger points.

When will my pain subside?

Most patients will experience pain relief after 3 treatments, but some patients report immediate pain relief after only one treatment. Over 80% of patients report less pain or no pain after EPAT therapy. Treatment sessions take approximately 15 minutes per injured area, but may vary depending on the injury. Usually three treatment sessions are necessary and are performed once every 7-10 days. If you are improving after the first three treatments but are not yet pain free, up to 5 treatments may be necessary.

How is EPAT performed?

Ultrasound gel is applied over the skin of the area to be treated. The pressure waves are then delivered using a special applicator tip which is moved over the injured area.

What are the possible side-effects of EPAT?

EPAT is a non-surgical treatment with virtually no risks or side effects. In some cases patients may experience some minor discomfort which may continue for a few days and/or the skin may become bruised or red after treatment.

Who should not have EPAT?

EPAT should not be used in patients who have deep venous thrombosis or malignancy. It is also best to avoid the procedure if you are taking blood thinners.

Will my insurance pay for EPAT?

Unfortunately, insurance companies do not pay for EPAT, though the cost of EPAT can often be reimbursed from a qualified health savings account.

Where Can I Get More Information About EPAT?

Dr. Bowling at Kentucky Sports Chiropractic in trained in providing EPAT treatment and is the best person to speak with.

EPAT photo (2)

More Gait Analysis

This gait analysis study I am particularly excited about. This runner was not in any pain when she presented to our office, she just felt like things were “off”. We were able to get to the cause and solution of the altered gait immediately and the corrections will go a long way to prevent future injuries. Have a look:

Pre/Post Gait Analysis With Voiceover

If you’re a biomechanics or anatomy nerd like myself, you’ll think this video is really cool. This is the format for which I conduct gait analysis studies in my office. Here I outline a bit what we’re looking for and more importantly, how we correct it. There is voiceover so be sure your sound is on. The measurements on the left are from before I made recommendations on corrective exercise and treatment. The measurements on the right were made after just two days of corrective exercise and one treatment. The results were significant.

Are You Overstriding?

Check out one of my latest Gait Analysis studies. Here we have a high mileage runner (60-80 miles per week) who has struggled with overuse injuries primarily on his RIGHT side. When evaluating him initially, we noticed that the musculature on his right side was much more pronounced than his left. After ruling out neurological involvement that might cause atrophy (decreased muscle mass), we decided to go to some video evidence. The culprit of this issue immediately jumped out at us. Look at how far out in front of his body his right foot initially touches the ground compared to his left. There is some major asymmetry going on here. Ideally, a runner’s feet should be striking the ground directly under or slightly in front of his/her body and center of gravity. When this does not occur, too much negative force is absorbed into our legs and injuries occur. While this rule can vary somewhat due to the speed and distance of the runner, this much of an asymmetrical stride is an issue and the cause of  his overuse injuries. Some ways to correct this include being evaluated for joint or soft tissue dysfunction which would be affecting range of motion, and practicing the “Pawback” drill which retrains your feet to land at an optimal location.

Break Up Muscle Restrictions and Scar Tissue With Graston Technique

 

 

A muscle with restriction as a result of adhesion or scar tissue that has been laid down during injury or overuse can become very problematic. Think of the muscle as a rubber band. Much like a rubber band, a muscle must be able to stretch and shorten at will. Then think of adhesion and scar tissue as  knots that have been tied in the runner band. The rubber band is not able to stretch nearly as much with knots tied in it, compared to stretching a rubber with no knots. Our muscles, tendons, ligaments, and fascia work in the exact same way. If these structures are restricted due to adhesion, they’re simply not going to work properly. Compensations and poor biomechanics take form which then makes us more susceptible to injury or re-injury.

A new technique using of specially designed stainless steel tools is changing the way clinicians treat these soft tissue dysfunction. Graston Technique is a form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break up adhesion that has developed from the overused and injured soft tissue. The technique allows the clinician to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.

Originally developed by athletes, Graston Technique is an interdisciplinary treatment used by more than 9,000 clinicians worldwide—including physical and occupational therapists, hand therapists, chiropractors, and athletic trainers.

Graston Technique is utilized at some 830 outpatient facilities and industrial on-sites, by more than 160 professional and amateur sports organizations, and is part of the curriculum at 38 respected colleges and universities throughout the united States.

The following conditions respond very well to Graston Technique:

-Fascial Adhesions / Scar Tissue
-Nerve Entrapments
-Muscle Strains (Acute or Chronic)
-Iliotibial Band (ITB) Irritation / Syndrome
-Anterior / Posterior Tibial Stress Syndrome (Shin Splints)
-Tendinopathies
-Runner’s Knee / Patellar Tendinopathy
-Achilles Tendinosis
-Plantar Fasciitis
-Snapping Hip Syndromes
-Post-Ankle Sprain Muscle Dysfunction
-Post-Surgical Scar Tissue
-Superior Tibiofibular Joint Fixation

For more information on Graston Technique, contact Dr. Kyle Bowling of Kentucky Sports Chiropractic at (502) 594-8326 or email at KySportsDoc@gmail.com

My Injury Prevention Series with Team in Training and The Courier Journal

 

 

 

 

 

 

Over the past month I’ve had the great joy and opportunity to work with Jessie Halladay during her training for the Dublin, Ireland Marathon on October 31. Jessie is a reporter for the Courier Journal and runs with Team in Training. Team in Training is a wonderful endurance training program that works to raise money to support the mission of The Leukemia & Lymphoma Society to find a cure for blood cancers by funding research and to provide important patient services and patient aid to blood cancer patients and their families.

Jessie has been blogging about her training and invited me to take part in a series of interviews on some of the most important aspects of injury prevention for the runner. I’ve linked all of the interviews below, check them out!

1) Importance of Proper Footwear

2) Running on Different Surfaces to Prevent Injury

3) Specific Stretching to Avoid Injury

4) Specific Strengthening to Prevent Injury

5) Gait Analysis for Efficient Running

For more information on Team in Training, visit their website Here.

Gait Analysis Lab Is Up and Running! (pun intended)

I’ve recently implemented a small gait analysis lab into Kentucky Sports Chiropractic. As I stated in a previous post, determining what kind of gait you have is imperative for successful injury prevention. Using a treadmill, specific lighting, and a high speed camera allows us to film a runner’s gait, then watch in ultra slow motion for asymmetry and/or biomechanical deficiencies while running.

To test out the new office addition, I decided to use myself as a guinea pig considering I have a significant history of overuse injuries in my left leg. The results were pretty surprising to me. Watch the initial video below and see if you can pick out what’s going on in my gait.

Pay close attention to the angle of my waist line when each leg strikes the ground. You’ll notice that when my right leg hits, my waist line and hips are completely level, this is optimal. However when my left leg strikes the ground, my waistline and hip slope down towards my right side. This is a classic example of having weak abductor muscles. For the runner, abductor muscles (specifically the gluteus medius) work to stabilize the hips and evenly distribute stress and impact throughout our lower extremities when striking the ground. If the hip stabilizers are weak and/or not functioning correctly (like with me!),   an overuse injury will inevitably occur as a result of the lack of stability.

To correct this, I’ve started a specific exercise regimen that targets core stability and hip abductors. We’ll reassess my gait in a few weeks to see the improvements.