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All Posts in Category: DR CRAIG EVANS DC

Ice or Heat for Injuries – Is the medical standard changing

A very interesting article appeared over at Spartan.com posing the question “Is RICE all wrong?”, and jumps to the question of Ice or Heat for injuries and it caught the eye of Dr. Andrew Gross and Dr. Josh Sand at out office because when we were in Chiropractic around five years ago, the automatic correct test answer in a lot of cases for injuries was ICE, there were rumblings that possibly RICE was going to be changed to something different.

For the most part RICE isn’t totally wrong, we just don’t feel it is as correct as it once was for all major injuries. Simply put icing most injuries is not a bad idea and safe. The idea of RICE comes from Dr. Gabe Mirkin MD who published a book about sportsmedicine (The Sportsmedicine Book) and ever since then the standard has been RICE which stands for Rest, Ice, Compression and Elevation. For around forty years now, Dr. Mirkin has been thought of as the authority on immediately icing an injury (along with compression and elevation.

We thought for a long time that icing the injury stopped, or at least limited the flow of inflammation to the injured region but we now understand that it only delays the processes. The newest ideas that numbing the injury only dulls the pain and sometimes does not permit you to feel the warning signs of pain being caused by injured tissue. The article linked below showed that 22 seperate studies found that “ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” A report in the Journal of Strength and Conditioning Research was even more alarming. Not only does icing fail to help injuries heal, the authors found, it may well delay recovery from injury. In 2017 The Journal of Athletic Medicine Research recently showed that icing actually kills muscle cells when they are iced for too long of a period post injury most likely from the direct effects of the inflammatory response of the injury being “held” directly on the injured tissue and not being pumped around due to the ice holding it there.

Taken directly from the article on Spartan.com —

“You might think that Dr. Mirkin would bristle at this blow to his erstwhile recommendations. Not so—he now openly rejects at least half of the RICE advice that helped make him famous. “I do not believe in cooling anymore,” he explained via email. Nor does he believe in the “R” component of his famous prescription either.
In a foreword to the second edition of Iced!, Dr. Mirkin says most athletes are far more concerned with long-term healing than transient pain relief. “And research,” he writes, “now shows that both ice and prolonged rest actually delay recovery.”

Check out the article for yourself at https://life.spartan.com/post/is-r-i-c-e-all-wrong

 

 

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Adrenaline Run Post Race Party Recovery Room – Haddonfield Adrenaline 5k

The Haddonfield Adrenaline 5k almost  always signals that we are at least getting somewhat close to spring in South Jersey.Just like last year we had the honor of setting up in the basement of the Haddonfield Running Co after the Haddonfield Adrenaline Run 5k. Per the norm we had the Physical Therapy team from The Training Room of Cherry Hill and The Training Room of Haddonfield along with us and they even brought there newest form of therapy, a cold laser. Runners, runner injuries, runner issues, and triathletes make up a very big part of our patient population and while some doctors offices don’t enjoy runners, we look forward to the challenge of getting someone feeling better with a goal in mind like a big race or a triathlon.

You can see the from the photos that follow that we had a full docket of our runners, friends and family looking forward to some Active Release Therapy after the race.

Questions about the big race?

The 13th Annual Haddonfield Adrenaline 5K Run will be held Saturday, March 17, 2018.  The 5k starts at 9am in front of Haddonfield High School and is followed by a kids 1/4 mile and 100 meter races on the Haddonfield High School track. The 5K race is USATF certified, and serves as the MidAtlantic 5K Championship. This event is sponsored by the RunningCo. of Haddonfield. Kick off the 2018 running season with an adrenaline pumping race!

This race sells out year in and year out! If you want to joint us next year to get your adrenaline pumping for the spring running season, be ready to sign up in late winter!

https://runsignup.com/Race/NJ/Haddonfield/HaddonfieldAdrenaline5K

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Villanova University – Day Of Distance Track and Cross Country Coaching Seminar 2018 Recap – The Running Works

For the second year in a row I was able to attend The Running Works Day Of Distance hosted by Marcus O’Sullivan at Villanova University! For the second year in a row I was blown away at the shear amount of running knowledge and sense of community the coaches in Pennsylvania (mainly the Philadelphia area coaches) and New Jersey (mainly the South Jersey coaches).  Shak and Cricket at The Running Works just keep putting on a better coaches clinic each year and it’s a lot of fun to meet the coaches from outside our region, South Jersey, and to see the look on their faces when they realize we are at cross country seminar for the various reasons we attend to better support our team and this year we even took a patient along who is looking to make the leap into coaching other triathletes very soon!

The day overall went by way too quickly! First off, Villanova’s athletic complexes are under a major overhaul right now and the transformation from last year to this year was a huge improvement! The football stadium and track may have been under snow to some extent, but you can see from the pictures below everything keeps getting better! We checked in around 8:00 AM and Craig Virgin, the famous American cross country and 10k meter racer spoke promptly at 9:15am. After a short break we jumped directly back into coaching talk with Chris Fox, the head coach of distance and cross country running from Syracuse University and recent Big East Champion and National Champion coach in Cross Country who politely reminded Villanova fans that to do that, you have to beat Nova and everyone had a good chuckle over that.  Lunch just might be my favorite part of the day because I get a chance to sit with coaches that I don’t know and hear about issues from coaches outside of our region like the western suburbs of Philadelphia and northern New Jersey.  The afternoon seminars I selected were with Phil Warton on Active Isolated Flexibility and Stretching followed by Marcus O’Sullivan on novice coaching solutions. Phil Warton’s session on stretching was very interactive and fun and he focused a great deal of his talk towards keeping young runner legs happy, including the hips! It was fun to see someone else who I have never met before “preaching the gospel” that happy hips make for good runner legs and improved spinal mechanics. The best part of my day, and my guest triathlete also agreed was “Novice Coaching Session with Marcus O’Sullivan” who broke down how easy it is to worry about to many variables when coaching high school cross country and while data and science can be infaliable, don’t forget when you are coaching middle schoolers, high schoolers, or even college kids to support them no matter what and to do the best to keep them healthy! Marcus when into how he almost retired from running and open road racing at age 32 because he had still never found a system of training before that which worked for him and it wasn’t until he started to let someone else help coach him along with decreasing the intensity of workouts from time to time based on blood lactate threshold levels and heart rate that he was then able to prolong her 5k and 10k racing career to the age of 37 and he joked several different times that he did it by listening to his body more and running hard a good bit less. Yes, you read that correctly, at 32 years of age, he ran almost as fast as he did at 22 in the prime of his career by listening to his coach and decreasing his high intensity mileage and working more on staying healthy.

 

Check out the pictures below!

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Resolving the causes and effects of back pain – Active Release – Dr Mark Kemenosh and Associates

Link to original content – http://activerelease.com/news.asp

Resolving the causes and effects of back pain – Active Release Technique – Dr Mark Kemenosh and Associates

One of the most common injuries that ART® providers treat, indiscriminate of their work setting, is lower back pain. Accordingly, it’s no surprise that lower back pain is the most commonly recorded musculoskeletal disorder. In the United States alone, it is the culprit of $100-200 billion in medical expenses each year. 80% of the U.S. population is affected by back pain at some time in their life. The high prevalence of back pain has enabled us at Active Release Techniques® to spend a lot of time studying the causes and most effective treatment protocols for each individual cause.

Back pain results from a wide array of working circumstances including heavy or repetitive lifting, over-reaching working in an awkward posture, and remaining bent over or seated for too long, just to name a few. These tasks create scar tissue, which causes pain, weakness, and reduced range of motion. Because of the large variety of behaviors causing back pain, cases of back-related MSDs can be found in nearly any workplace setting, from offices to factories. Whether the activity causing the pain is sitting, reaching, or lifting, pain origination is frequently linked to doing any of these activities with an awkward posture. Additionally, as people age, their incidence of back pain rises as does the cost, which increases at a greater rate due to the increased time, medication, and procedures necessary for their recovery.

Sitting puts twice as much stress on your back as standing, and when you slouch that stress is compounded. Further, sitting in a slouched position over-stretches the ligaments in your back. Not only do sitting and slouching add stress, they also prevent nutrients from getting to the discs in your spine. Excessive sitting can also cause pain in your hips and pelvis because it tightens and shortens the tendons in that region, placing even more pressure on the lower back. Pain resulting from maintaining an awkward posture, such as crouching or bending for an extended period of time, is often caused by some variation on this same reasoning.

Back pain as a result of heavy or repetitive lifting is also frequently a function of lifting with an awkward or incorrect posture. The weight being lifted adds additional stress to the spine, and awkward posture exacerbates the issue by causing muscles, tendons, or ligaments to over-stretch or tear.

So many of the things we do every day can build up scar tissue over time and cause back pain. Luckily, ART® can help, not only to relieve your pain and release your scar tissue, but also, through our onsite wellness programs, suggest things that you can do to prevent that scar tissue from building up in the first place.

Link to original content – http://activerelease.com/news.asp

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Knee Pain – A common injury with many causes – Dr Mark Kemenosh and Associates

Link to original content – http://activerelease.com/news.asp

ART® has a long history working with athletes of all kinds, and was actually developed when the founder, Dr. P. Michael Leahy was working with elite athletes to help them get back to peak performance more quickly. No matter the kind of athletic endeavor in which you partake, knee injuries are a common frustration that can be resolved with ART® In addition to being extremely prevalent, knee injuries can also be some of the most nagging, because they can take a long time to come back from, and can stop people from working out or training for weeks or months.

The knee must support body weight as well as flex and extend to generate the propulsive forces needed to move the body. To help the knee serve its very important function, it is surrounded by a complex group of muscles that must be strong, flexible, and coordinated enough to protect and stabilize the knee.

Knee injuries are so common because the knee is interconnected with other joints, namely the hip and the ankle, as a part of the kinetic chain. The knee is a hinge joint that is designed to move backward and forward, but the other joints in the kinetic chain, the hip and ankle, move front to back, side to side, and around in circles. Understanding how pain in one joint can come from elsewhere in the kinetic chain is an important part of how ART® providers diagnose a soft-tissue injury. Very often, knee pain is symptomatic of issues in the adjacent muscles or joints. If the hip or foot has even a minor issue such as over-tightness, weakness, muscle imbalance, or faulty alignment, it can overload the bones and ligaments in the knee, and places even more demand on the muscles around the knee as they try to keep it from moving from side to side or twisting.

When there is a problem anywhere in this kinetic chain, the knee is often the first place to develop pain, even if it is not the source of the problem. This is referred to as movement compensation. The forces generated by any athletic activity do not get properly distributed and they become focused at the knee. For this reason, when diagnosing knee pain, ART® providers know that they must examine the entire kinetic chain, and not just the knee and its surrounding muscles. Treatment that focuses on just the knee often results in re-injury because the root of the problem is not addressed.

Traditional treatments for knee pain often involve some combination of heat, ice, ultrasound, muscle stimulation, steroid injections, exercises, and sometimes even surgery. Many of these methods are ways to temporarily relax the muscles, and all of them deal exclusively with the knee and the muscles surrounding it. These treatments often take a long time to see significant results, and even then those results are temporary and the injury usually recurs. This is because the root of the problem has not been addressed, the entire kinetic chain has not been examined, and scar tissue has not been released.

An ART® provider watches you move and examines the entire kinetic chain using tactile observation to feel the texture and tension of each muscle, and releases the scar tissue that sustains the injury with palpation. This assures that the root of the problem is addressed and keeps the injury from happening again. Best of all, ART® treatment delivers noticeable results in just one 15-minute treatment and can resolve the injury completely with just 5-10 treatments, so you can get back to your active lifestyle as quickly as possible.

Link to original content – http://activerelease.com/news.asp

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Running Works – Day Of Distance 2018 – Date Announced – Friday, March 16, 2018 at 8 AM – 4 PM

We know it’s early but we are charged up about keeping running alive and well in our region of South Jersey! All too often we hear running community members say if they would have only known about the Day Of Distance earlier they would have signed up! Well it’s on and the date is Friday, March 16, 2018 8 AM to 4 PM.  While we don’t have all the details just yet, we can tell you that the Running Works team has started to circulate a Facebook Event Page confirming the date, time, and the location, which is always, Villanova University.

Day Of Distance Facebook Invite Page – https://www.facebook.com/events/1905653229751357/

So far the keynote speakers for 2018 will be Craig Virgin and Chris Fox.  We will post more info when we know about it!

Here are some pictures from the 2017 Running Works Day Of Distance –

Here are a few pictures of Dr. Mark Kemenosh speaking at the break out sessions of the 2016 Day of Distance on the benefits for Active Release when applied to cross country and track and field athletes!

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Haddonfield Adrenaline 5K Race Walk and Kids Race – HADDONFIELD, NJ –

Holy smokes, it’s almost time for Christmas, New Years and so much more! Where did 2017 go? Is Cross Country really already over? Well, I guess it’s time to plan for spring and there is no better way to break out of a winter time funk than to sign for up the Haddonfield Running Co Adrenaline 5k Run/Walk and Kids Races! Inside tip, we usually setup in the basement of the Running Co for a post race recovery room with the Training Room of Haddonfield Physical Therapy group!

Place

Haddonfield Memorial High School
Haddonfield, NJ US 08033

Race Description

The 13th Annual Haddonfield Adrenaline 5K Run will be held Saturday, March 17, 2018. The 5k starts at 9am in front of Haddonfield High School and is followed by a kids 1/4 mile and 100 meter races on the Haddonfield High School track.

The 5K race is USATF certified, and serves as the MidAtlantic 5K Championship. This event is sponsored by the RunningCo. of Haddonfield. Kick off the 2018 running season with an adrenaline pumping race!

Team Challenges

Note: No Race Day Team Registration.

Corporate Team Registration allows an organization to pay for their employees and families. Click on Corporate Team and Create New Team.

Competitive teams will still be the same:

3 to a team to score, no maximum. Awards to top 2 teams in each of the following categories:

– High School Club Team (Male and Female)

– Family Team

– Corporate Team

Packet Pickup

March 14-16 from 10AM – 7PM at RunningCo. of Haddonfield, 121 Kings Highway East, Haddonfield, NJ 08033.

Race Day Packet Pickup at Haddonfield High School starting at 7AM.

Directions

From the Ben Franklin Bridge, take Rt. 30 East. Follow signs for “Cherry Hill”. After ramp, take Route 70 East about 3 miles to Route 41 exit to Haddonfield, continue straight. After the second traffic light, Park Ave., Haddonfield High School is on your right. Follow signs for parking.

From Rt. 295, take Exit 32 – Haddonfield/Gibbsboro. At the end of the exit ramp, turn onto Route 561 West (Haddonfield/Berlin Road) towards Haddonfield. Travel straight on Route 561 for about 3 or 4 miles, make a right onto Kings Highway, Haddonfield High School is on your left. Follow signs for parking.

Cash Prizes

Top 5 Overall Male and Female Runners:

1st – $400
2nd – $250
3rd – $150
4th – $100
5th – $50

Top 3 Overall Masters Male and Female

1st – $100
2nd – $75
3rd – $50

Awards

Finishers medals for all runners. Wait til you see the 13 year design!!! St Pats Special!!!!

Awards to Top 3 Male and Females in the following Age Groups: Under 14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70+.

Link to SIGN UP — https://runsignup.com/Race/NJ/Haddonfield/HaddonfieldAdrenaline5K

Hosted by the Running Co of South Jersey – Haddonfield, Moorestown, Mullica Hill, and Medford

Link to SIGN UP — https://runsignup.com/Race/NJ/Haddonfield/HaddonfieldAdrenaline5K

Pics from years gone by and a short jaunt down memory lane of the Haddonfield Adrenaline 5k – All photos are thumbnails! Click on them to see more detail!

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Atrophy of gluteus maximus among women with a history of chronic low back pain

Saw a nice article recently post from our neighbors over at Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania, 2 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, 3 Department of Biomedical Education and Anatomy, The Ohio State University, Columbus, Ohio.

Article Title: Atrophy of gluteus maximus among women with a history of chronic low back pain

Methods:  For this case-control study, we analyzed medical history and pelvic computed tomography (CT) scans for 36 female patients with a history of chronic LBP, and 32 female patients without a history of LBP. Muscle cross-sectional area of gluteus maximus was measured from axial CT scans using OsiriX MD software, then was normalized to patient height, and used to compare the two groups. The number of back pain-related medical visits was also correlated with gluteus maximus cross-sectional area.

Conclusions: This research demonstrated a previously only minimally explored relationship between gluteus maximus cross-sectional area and LBP in women. Further research is indicated in individuals with varying age, sex, and LBP diagnoses.

Direct Link: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177008

Take away ideas from this study in a nut shell:  

This research confirmed Thomas Jefferson’s Physical Therapy Researchers hypothesis that Glute Max atrophy would be greater in individuals with chronic LBP. Further research is indicated on Glute Max CSA in individuals with varying age, sex, and LBP diagnoses. Research on the potential impact of exercise interventions targeting GM in individuals with chronic LBP is also indicated.

If you are struggling with low back pain, we can almost always help! We combine chiropractic, active release, home exercise programs and much more to the treatment of all types of back pain. Give us a call at 856.228.3100 for more information or send us an email a the link below!

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Injured Redskins turn to chiropractor to recover quickly – Richmond Times

Earlier this month a great article went up on the Richmond Times about how Washington Redskins players were turning to Chiropractic Medicine to return to the field quicker. We love great information about Chiropractic, Active Release Technique, and Instrument Assisted Soft Tissue work! The best part of the story is that the Chiropractor helped him with his Achilles injuries, just like we do at our office here in South Jersey. We do a lot more than just low back pain and neck pain, check out the article below for more info.

Link: http://webcache.googleusercontent.com/search?q=cache:1RIqXi4TG5cJ:www.richmond.com/redskins-xtra/injured-redskins-turn-to-chiropractor-to-recover-quickly/article_a72268f8-3bac-598e-94b3-dda2761f5310.html&num=1&hl=en&gl=us&strip=0&vwsrc=0

From the article:

Running back Mack Brown watched Josh Doctson’s college film this offseason, seeing clips of his teammate toe tapping in the end zone, high pointing passes and running crisp routes rolled into five-minute YouTube videos.

Doctson tried TheraBands to fix his Achilles injury, he tried stretching it and none of it helped reclaim his health. Brown knew what Doctson could do for the Redskins’ offense this season, so he recommended Doctson see Dr. Craig, a chiropractor in the Ashburn area who Brown visits for body maintenance.

“I knew he really was in pain. I was like, ‘You really need to go to this doctor to get your body worked on,’” Brown said. “You get Doctson at 100 percent, he’s a problem for the league, one of the best receivers in the league. We need to get him back healthy.”

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The New York Times – Bring On the Exercise, Hold the Painkillers

Over the weekend a fantastic article that speaks to a team of chiropractors like we have at the office appeared on my social feeds! On The New York Times Running Newsletter the following article was published about exercise and why some forms of NSAID’s and Painkillers and endurance athletes like runners, swimmers, and cyclists should think first before just dismissing the issue and reaching for ibuprofen or naproxen in most cases.

Taken directly from the article by Gretchen Reynolds:

Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles’ ability to recover afterward.

Direct Link: https://www.nytimes.com/2017/07/05/well/move/bring-on-the-exercise-hold-the-painkillers.html?em_pos=small&emc=edit_ru_20170707&nl=running&nl_art=1&nlid=80378830&ref=headline&te=1&_r=0

NSAID use is especially widespread among athletes in strenuous endurance sports like marathon and ultramarathon running. By some estimates, as many as 75 percent of long-distance runners take ibuprofen or other NSAIDs before, during or after training and races.

Being a marathoner myself I cannot refute the fact that on occasion I do take the label dosage of ibuprofen but understand that in most cases this is a poor choice for dealing with a running issue.  While most outsiders think of our office as “just another chiropractic office” we also offer Active Release Technique, commonly referred to as “ART” and in sports like running, cycling, and swimming, we usually offer a huge amount of upside with treatment to all sorts of issues commonly encountered.  I have even broken myself to some extent to not use ibuprofen (advil) or naproxen (aleve), which at times is tough with very small injuries that often times only slow me down, but do not keep me from running and going to the gym.

Some other valuable links about “pills” and runners / endurance athletes to check out are the following!

The Pill Problem – The right drug can relieve pain and discomfort—or put you in a world of hurt.

Direct Link: http://www.runnersworld.com/injury-treatment/what-runners-should-know-about-pain-medications

From the article written by Christie Ashwanden:

After winning a 24-hour track run in record time, Stephanie Ehret should have been celebrating. Instead, she was in a Phoenix emergency room, vomiting up a strange substance, which a doctor informed her was part of her digestive-tract lining. Feverish and nauseous, Ehret could barely move. “I’d never felt so bad,” she says. “I was pretty sure I was dying.”

A few hours later, doctors diagnosed the problem—rhabdomyolysis, a potentially fatal precursor to kidney failure. Though dehydration and overexertion contributed to Ehret’s condition, doctors told her that the 12 ibuprofen pills she’d taken during the 24-hour race had pushed her kidneys into the danger zone.

When used properly, over-the-counter pain medications can be a godsend. Acetaminophen (Tylenol) can tame many pains. And non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and naproxen can reduce pain and swelling in the first few days following an acute injury like an ankle sprain. The trouble comes, doctors say, when people, like Ehret, misuse these drugs. “A couple of ibuprofens really helped, so I figured more was better,” Ehret says. Indeed, many runners treat anti-inflammatory drugs like “vitamin I,” says pharmacologist Joe Graedon, coauthor of The People’s Pharmacy book series. “They think, I’m putting my body through a lot, so I’ll just dose up on ibuprofen, without appreciating how potentially dangerous this drug can be.”

The Dangers Of Mixing Meds While Running

Direct Link:  https://houseofrunning.com/the-dangers-of-mixing-meds-and-running/

From the article written by Laurie Villarreal for House of Running –

I was at the start of the CPC half marathon last weekend when a runner said to me that she had just taken some ibuprofen for a headache. I immediately thought, “oh no, bad idea.” While ibuprofen might help with a headache or with post-race inflammation, it can be too risky to take before a running event. This is something that I never do. Before mixing medication with running, it’s quite important for you to know the risks as well.

Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug), which can be particularly risky for runners. NSAIDs also include the common drugs aspirin and naproxen, as well as many others. When taken before or during a run, it can cause harm to your kidneys, increase your blood pressure to risky levels, and put you at greater risk for hyponatremia. No matter the reason for taking an NSAID, it is not often worth the risk.

The best part about being a chiropractor who specializes in Active Release Technique here in South Jersey is that more than likely we can correct most running issues using hands on Myofascial Manipulation coupled with treatments like Instrument Assisted Soft Tissue Manipulation and some NATURAL anti-inflammatories to keep you running, biking, swimming, cross fitting, ninjaing and more at a very high level!

Questions?  Give our front desk a call at 856-228-3100 or use the contact us link below!

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