Femoroacetabular Impingement (FAI), or hip impingement syndrome, is a painful hip condition that limit a person’s activities and can inhibit an athlete’s ability to perform. Many times people can function just fine with an FAI, depending on their activity, but many times it’s necessary to get surgery to correct the problem. After surgery though, proper rehabilitation is necessary so as to reduce scar tissue buildup in the hip joint region. There are 3 types of FAI and each one can cause significant problems. Continue Reading →
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Oct 2017
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Jul 2017
Meralgia Paresthetica…What Is It and How Is It Treated?
Meralgia Paresthetica aka Roth’s Disease aka Lateral Femoral Cutaneous Nerve (LFCN) syndrome is a condition we see from time to time. The patient tends to present with pain in the lateral thigh that almost feels like an itchy feeling. The discomfort can be anything from burning pain to tingling. The pain is not a deep pain but is superficial. This means you only feel it on the outside of the thigh vs. deep in. It can be very bothersome and it is certainly annoying enough that people will go to find a solution. Left untreated, it tends to get worse with time. Continue Reading →
22
Jun 2017
Elbow Pain…What The Heck Is The Issue?
The elbow…well, it certainly isn’t the ‘funny/crazy bone’ when we hurt it.
The elbow…when it hurts, it certainly isn’t so ‘funny’ or ‘crazy’.
We treat a LOT of elbow problems in our office. Why is this? Well, we have an active patient base and most all we do affects the musculature in our elbows. It used to be that when you had medial, or inside, elbow pain, that would be called ‘golfer’s elbow’ and when the pain was on the lateral side, or outside, that was called ‘tennis elbow.’ Well, needless to say, times have changed and people in many sports get medial and lateral elbow pain and they certainly are not playing golf or tennis. For that matter, not all golfers get medial elbow pain and tennis players lateral elbow pain anyway…sometimes, it’s the opposite. As as far as that ‘funny bone’ issue we’ve all heard about, that occurs when we bang a certain part of the elbow that the ulnar nerve runs through. The sensation we feel is irritation to the nerve and the distally affected tissues feel ‘funny.’ Continue Reading →
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Apr 2017
Golf: Hip Rotation And Its Effect On Early Extension
As a certified Titleist Performance Institute (TPI) level 3 medical provider, I get the honor of treating a lot of golfers. As golfers will tell you, the game is like a heroin addiction…but it’s actually more expensive! A golfer will do just about whatever it takes to improve his/her game. From shoes to gloves to clubs to lessons to whatever, nothing is too much if it will shed a few strokes off each round. Whether the golfer is a 20 handicap or scratch or better golfer, improvements can always be made. As is the case with any sports activity, proper stability and mobility are important and for a precision game like golf, they’re vital.
One major movement fault that many people and golfers alike have is a lack of internal hip rotation. Proper hip mobility is not only vital for back health, but it is vital for proper swing mechanics. I’d say, in my experience, that about 80% of golfers suffer from this issue. It can be on the either side and depending which side it is on, the fault affects the backswing or the follow-through. Regardless of which one it is, it must be corrected to improve that score and lower the risk of musculoskeletal injuries…mostly, the force transmission into the low back. This is one of the major reasons why so many golfers get low back pain. Continue Reading →
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Mar 2017
The Achilles and Two Reasons Why It Might Be Hurting You
Figure 1.: The Calcaneal Bursa Sacs, picture from WebMD
The Achilles tendon is a rather avascular (lacking blood) thick tendon that is made up of two of your major back side calf muscles: the gastrocnemius and the soleus. The tendon attaches into a part of your heel bone, the calcaneus, and this part is called the calcaneal tubercle. We have to major bursa sacs (bursa sacs are pockets that only fill with fluid when they are inflamed), the subcutaneous calcaneal bursa and the retrocalcaneal bursa (see figure 1 right). The subcutaneous bursa seldom presents as an issue, but the retrocalcaneal bursa can be a major headache. Continue Reading →
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Mar 2017
Why Your Back Might Not Be Getting Better
There are many reasons as to why people develop back pain and luckily, conservative treatment can help most all of them. Only in the rarest of instances is surgery needed. The problem with treating back pain is that all too often the practitioner focuses so much on the pain that he/she doesn’t actually address what is causing the pain. We’ve all been guilty of this!
I could write volumes on contributing factors to back pain but this blog was written to address one common problem that we are seeing more and more: a hypermobile sacroiliac joint (SIJ). Now, the naysayer will try to suggest that this does not occur, but with over 18 years of treating sports and back injuries, I can assure you that it does, and it does with frequency. I’ve seen this problem in active kids to my professional athlete clientele base. It is usually not properly diagnosed as few practitioners know how to assess it. Continue Reading →
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Feb 2017
The Truth About Plantar Fasciitis and How To Treat It
Plantar Fasciitis (PF) can be a rather debilitating condition. It doesn’t matter if you have flat feet (pes planus) or high arches (pes cavus). If there is added stress to the bottom of the foot that occurs quickly, it can result in plantar fascial pain.
What exactly is the plantar fascia? Consider the plantar fascia to be similar to a ligament. It runs from the heel (the medial calcaneal tubercle) to the heads of your metatarsals (point at about where you see the webbing of your toes). Despite what you might have been told, its function is NOT to hold the arch of the foot. Rather, the PF more-so holds the muscles under it together so that they can suspend your arch. Continue Reading →
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Feb 2017
I Have Disc Problems and I Cannot Run…Will I Be Able To Run Again?
We treat a lot of patients who suffer from disc pathologies, be they bulges or herniations. Most of these people are active and want to continue to be active. The problem they encounter is that they get pain in the low back with activity that many times goes into the gluteal region (on one side or another…or both) and sometimes goes down the leg(s) into the feet. This makes it hard for them to partake in sport. Continue Reading →
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Feb 2017
The Dreaded DCO and What It Means To You and Your Shoulder!
DCO, or Distal Clavicular Osteolysis, is a rather bad shoulder condition that all too many athletes suffer from.
DCO occurs when we have damage to our AC (acromioclavicular) joint and it goes unattended to for a period of time. More-so than that, additional damage is done with further activity and the bones that make up the joint get significant damage.
The AC joint is made up of where the distal clavicle bone meets the acromion process of the scapula (see photo below). A sprain of the AC joint tends to involve a macrotrauma (one significant injury) such as a bad fall or other form of side shoulder impact. The AC joint tends to get hypermobile (or move too much) easily as it is not a very stable joint to begin with. When the joint is injured, or sprained, care is needed to stabilize the joint and allow for it to heal. In-office treatments can significantly reduce recovery time and this is important as a healing AC joint sprain is susceptible to further injury. Continue Reading →
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Jan 2017
The Biceps Tear…What You Should Know
There are two heads to the biceps brachii, the long head (that goes from the labrum to just past the elbow…the outside one in the picture) and the short head (that goes from the coracoid process to just below the elbow…the inside one in the picture). We rely on each muscle for shoulder flexion, elbow flexion, and some supination (hand rotated upward) of the forearm/wrist/hand. Of the two heads, the long head tends to tear more as it thins out as it travels into the shoulder and it is more susceptible to damage at its attachment on the shoulder labrum.
The muscle can tear due to age-related wear and tear, labral tearing, overuse and trauma. Generally, muscles tear from either the origin (where it begins proximally), or the insertion (the distal attachment). When the biceps tears from the insertion, it will tend to roll up the arm and form a ball in the middle of the biceps region. This type of tear tends to be very noticeable. Continue Reading →
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