Your Choice For Active Release, Sports Injury, and Chiropractic Care

Schedule an Appointment, Call : 856-228-3100

Locations : Laurel Springs, Haddonfield, Mt Laurel, Somers Point, and Washington Township, NJ

All Posts in Category: Foot Pain

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!

Contact

Find Us On Facebook

Find Us On Facebook!

Read More

Rocktape – Kinesiology Tape Instructions – Plantar Fasciitis ( Video )

Here at the office we see Plantar Fasciitis “limp”, “stumble”, and “trot” in just about everyday and now that “running season” has sprung with SPRING, we expect plantar to start coming in even more as we progress towards summer here in South Jersey.  Here at the office we use Active Release Technique, IASTM with SMART Tools (Instrument Assisted Soft Tissue Manipulation), kinesio tapes like Rocktape, and chiropractic extremity manipulations.  We see cases that have already been injected by podiatrists and orthopedics a like with only limited success.  We are simply sharing this video because we see a lot terrible tape jobs so give this one a try!

Check out some of our older blog posts about Plantar Fasciitis and found out more and why we help people fix their feet everyday here at the office!

Plantar Fasciitis: Active Release is truly a different type of attack for Plantar issues

Link: http://drmarkkemenoshandassociates.com/plantar-fasciitis-active-release-truly-different-type-attack-plantar-issues/

Plantar Fasciitis and Shin Splints – Why doesn’t Active Release and Instrument Assisted Soft Tissue Manipulation pop up on Google sooner?

Link: http://drmarkkemenoshandassociates.com/plantar-fascitis-shin-splints-doesnt-active-release-instrument-assisted-soft-tissue-manipulation-pop-google-sooner/

Very interesting article talking about not needing a chiropractor, but checking out Active Release

Link: http://drmarkkemenoshandassociates.com/interesting-article-talking-not-needing-chiropractor-checking-active-release/

Plantar Fasciitis – Heel Spurs – HokaOneOne Bondi’s and so much more.

Link: http://drmarkkemenoshandassociates.com/plantar-fasciitis-heel-spurs-hokaoneone-bondis-much/

If you or someone you know is struggling with pain in the bottom of the foot, let them know we go after plantar issues much differently than anyone else in South Jersey.  Our office number is 856-228-3100 and you can always use the contact us email link below!

Contact

Read More

Prevention.com – 4 Things You’re Doing That Are Ruining Your Joints

Dr Tim Legath forwarded me this article the other day and stated he thought it would be important if we linked it up on our blog! Before you go reading some of what has been copy and pasted below, you need to realize that we share this information for everyone’s benefit and that we are not trying to knock running, yoga, or pilates, but hoping that you need to realize that a wide variety of exercise and cross training best benefit your joints.

Prevention Magazine:  http://www.prevention.com/fitness/4-mistakes-making-joints-weak

The following is taken from the article written by CASSIE SHORTSLEEVE

“It used to be that joint replacements were a problem for older people. But today orthopedic surgeons are seeing people in their 40s, 50s, or younger. In fact, surgeons at The Mount Sinai Hospital in New York City say the number of people younger than 60 going under the knife is up at least 15% in the last 2 years. Plus, data from the National Center for Health Statistics finds the number of hip replacements more than doubled in a 10-year span, skyrocketing by 205% in people ages 45 to 54.
Surgeons attribute the rise to people wanting to stay active while they age, says Calin Moucha, MD, chief of adult reconstruction and joint replacement surgery at The Mount Sinai Hospital. Today’s implants also last longer than they once did, sometimes up to 40 years, he says. This means joint replacements are now an option at a younger age, since physicians aren’t as worried about having to replace them.”

So what does this all mean to you?  Well, our runners might not like what comes next…

“You’re a runner and only a runner.

Moucha says that many patients seeking joint replacement are in good cardiovascular health, but not necessarily good physical health. If you’re running marathons or triathlons only, you might have imbalances when it comes to muscle strength and flexibility. And this, paired with repetitive trauma over time, could lead to arthritis, he notes, causing your joints to wear away. 

“It’s important to cross-train,” says Moucha. Giving certain muscle groups (like the ones you use on long, slow jogs) a break once or twice a week while activating new muscles (like the ones you might use sprinting) can fend off injury, he notes. (You should consider working these strength-training moves into your exercise program.)”

Well what about all that Yoga that I do?  That’s probably good for me right?…

“You push yourself beyond your limits in yoga.

Intense workouts like HIIT and mud runs aren’t the only way to injure your joints. While yoga and Pilates are great ways to boost flexibility and strength, anything extreme when it comes to range of motion—like reaching for that pose your body’s not quite ready for—can put you at risk for a joint injury, notes Moucha. “When you create range of motion extremes, you can create bony spurs (projections along a bone’s edges) that may predispose you to arthritis,” he says. Your best bet isn’t to skip yoga but rather to stick with the modifications that work for you, and give yourself time before trying anything you might not be ready for.”

Check the article out for yourself today!  The link is below.

Prevention.com Article:  http://www.prevention.com/fitness/4-mistakes-making-joints-weak/

Read More

Calling all Philadelphia and South Jersey manual therapists! We are hosting SMART Tools with The Training Room!

Dr. Mark Kemenosh and Associates with the help of our good friends at The Training Room Physical Therapy group of South Jersey are proud to announce we are hosting the SMART Tools Level 1 IASTM certification at our shared facility in Washington Township aka Sewell, NJ.  We are putting the word out to everyone in manual medicine who would like to come out to feel welcome!  We plan to have DPT’s (Doctors of Physical Therapy), DC’s (Doctors of Chiropractic),  ATC’s (Athletic Trainers), and possibly more attending this event!  The course is a full two days and will be held on July 29th and 30th, a little down the road in the middle of summer!

SMART TOOLS – LEVEL 1 CERTIFICATION – SEWELL, NJ

Date: Sat July 29 – Sun July 30, 2017

Time: 8am – 5pm (each day)

Venue: The Training Room of Washington Township (Inside Velocity Sports Performance)

309 Fries Mill Rd
Sewell, NJ 08080

This course lays the foundation for how to properly use the SMART Tools most effectively with respect to movement. The tools were made specifically for these technique protocols to produce superior patient outcomes compared to other IASTM technique. This is an evidence-based technique that stresses early loading exercises and kinesiology tape after SMART Tools treatment.

The goal of therapy is to provide an optimal environment for the healing, by either modifying physiologic responses to injury (e.g., inflammation, muscle spasms, pain) or enhancing components of the normal musculoskeletal function (e.g., increase range of motion, increased muscular strength). No single therapeutic approach in isolation will completely resolve an impairment of musculoskeletal function. Smart Tool Plus® represents an approach to soft tissue manipulation that uses five different stainless steel instruments to release scar tissue, adhesions, and fascial restrictions. SMART Tools are designed to be used in conjunction with a thorough medical evaluation, movement based examination and other modalities to help patients overcome injuries.

Therapeutic stretches and exercises (preferably eccentric exercises) are necessary to promote tissue lengthening and collagen fiber realignment, which help to prevent the released tissue from becoming restricted again.

The primary objective of the Level 1 Certification course is to develop an understanding of the STP and how to apply it into the full spectrum of the musculoskeletal treatment approaches. By the end of the training, students will be able to:

Demonstrate a working knowledge of the STP Instruments, STP treatments and potential effects and benefits.
Identify and discuss the indications, contraindications (relative and absolute) of IASTM.
Review and develop a better understanding of soft tissue injury, healing and potential reactivity to instrument-assisted soft tissue mobilization (therapeutic and adverse).
Develop skill and competence in the STP application of the IASTM to the major regions of the spine and extremities.

Treatment effects of IASTM

  • Breakup abnormal densities in tissue
  • Stimulate nervous system
  • Reinitiate first-stage healing in the body via proliferation
  • SMART Tools IASTM techniques aim to treat the following Tissue Extensibility Dysfunctions

(TEDS):

  • Scarring & Fibrosis
  • Facial Tension & Densification
  • Neural Tension
  • Muscle Shortening
  • Neurologic Restriction
  • Trigger Points

This isn’t Gua Sha, nor is this another general IASTM course. This is a movement-based IASTM course unlike anything currently offered. Our training course addresses the neurological component, as well as the physiological component of the IASTM and corrective exercises in ways other courses do not.

This course is designed for clinicians that either have never used tools or have been using tools for years. Each will come away with new, innovative material.

So if you want faster patient outcomes, quicker recovery time, improved clinician ergonomics to save your hands, and last but not least, no patient bruising, then register for a course today and add a powerful technique to your toolbox… no pun intended.

Need more info?  Ready to register?

LINK:  http://www.smarttoolsplus.com/product/level-1-sewell-nj

 

 

Need more info?  Ready to register?

LINK:  http://www.smarttoolsplus.com/product/level-1-sewell-nj

Read More

So tell me about these Aline Performance Insoles all you Docs are testing out!

So for about the past month we have been testing and tuning our own Aline Orthotics (Performance Insoles) as we prepare to start fitting them semi regularly for our patients.  For the first time in a long time we are excited about an orthotic because Aline truly has a product that works very well with MOST feet.  These orthotics are also affordable, making them even more enticing as an offering for our patients.

Here is some of what we have been testing and tuning the past few weeks since having a sit down training session with training and fitment team from Aline.

First off, here is the Aline base station.  It’s simple, effective and you can within a few moments if you will likely benefit from Aline performance insoles and where we can add in physical adjustments to help with pronation and supination.

Lets start with Dr. Josh Sand’s hiking setup.  As you can see in the following pictures, Josh just picked up a new pair of Merrell hiking boots and immediately started using his Aline Golf Insoles in them to test them against Aline Active Insoles in his older Merrell hiking boots to see how they both performed.  Josh said surprisingly both pairs felt great, he feels that he is only slightly more interested in wearing the golf model because they are in his new boots and that both pair have felt great for him other than some increased muscle soreness in his peroneal muscle groups (lateral  shin muscles that help to stabilize the foot).  The only slight complaint Dr. Josh has is that the golf insoles are slightly tacky due to the top layer of the insole being designed for feeling the ground underneath you as much as possible and gripping through during the golf swing.

 

I, Dr Craig Evans, have been testing the cycle models because our Aline rep alerted us that the Active and Cycle models are both designed for highly active individuals and were designed with running/tri-athletes/hikers in mind.  I have not been doing as good of a job with taking pictures of my orthotics testing as Dr. Sand and am admittedly an orthotic basher to some extent due to my past medical history.  Sometime around my freshman or sophmore year of high school my parents spent around $600 (or more) on hard orthotics for me to help curb some tendinitis issues that I was hard casted for several times during my high school basketball career.  I was permitted to play through the pain to some extent with prescription for NSAID’s but often spent the following spring and summer in a walking cast in an attempt to calm down my Achilles tendon.  Looking back now I’m guessing that walking boots were not invented at that time and I am almost glad because I would have probably taken it off.  For the most part however, I never wore those hard orthotics longer than a week because they were almost downright unbearable at least for me.  They felt like rocks and nothing that I could do could make it any better.  From that day forward I have been picky about what shoes I wore and was able to remain somewhat pain free in the Achillies tendon region by keeping up a strength training regimen and fell this is what greatly helped me leading into my senior year.  The summer before my senior year of high school a new Orthopedic, fresh out of med school from Canada saw me and forced me into a physical therapy regimen that I still keep somewhat going to this day.

Below you can see the Aline Cycle insoles that are currently in my Adidas Boost ESM 3’s.  It took an honest week of walking and three 5k runs on the treadmill for me to settle into them well.

The Aline Cycle performance insoles have an integrated fabric mesh that helps to keep the insole slim.  The orthotic is designed with sports like running, cycling, and soccer in mind!  These insoles feature the exact same support and technology as the Aline active models with a slightly different top coating.

Here are some of the other models we are actively keeping in stock as well.  The yellow models are the Aline Active + models and they offer support as well as comfort with just a bit more padding.  The Aline Active + models are popular with all types of athletes including tennis, runners and they work well in everyday footwear.

 

The Aline Active performance insoles are clear with red inserts.  They are designed for all day activity and used by many of the Aline professional athletes.  Aline Active performance insoles are the most popular Aline model by far.

 

Interested in some performance care or seeing if Aline orthotics can help you?  Please feel free to give our office a call at 856-228-3100 or you can email us at our Contact Us Page linked below!

Contact

 

Read More

SMART Tools – ITBand Treatment (Short Version)

So a lot of our patients have issues with pain, tenderness and tightness in and around the Iliotibial Band, often times referred to as the ITBand.  While in most cases there are various reasons why our patients present with pain in this particular tissue, treating it has been done various ways in the past, some with great success and some with no success.  Here at the office we do our best to treat each patient individually using a mixture of treatment methods best on several things like the presentation of the patients issue, where it is located on the ITBand (near the hip, in the middle of the femur, or at the lateral border of the knee) and the mechanism of injury or in some cases the mechanism of aggravation (take that runners, cyclists, and crossfitters, I have a new way of explaining to you guys and gals who like to say to me “but I never actually hurt it”).

In all conditions, the first thing most patients do is GOOGLE IT to see what comes up.  In most cases of googling things that sound like ITBand Syndrome, here is an excerpt of the results.

Iliotibial band syndrome occurs when the connective tissue (ligament) extending from the pelvic bone to the shinbone becomes so tight that it rubs against the thighbone. Distance runners and cyclists are especially susceptible to it.

The main symptom is pain between the hip and knees that worsens with activity.

Treatments such as physical therapy and sometimes corticosteroid injections may help. In rare cases, surgery may be needed.

In my opinion, the only thing Google got right in the treatment section is that physcial therapy almost always helps because a good physical therapist will help you strength the posterior gluteal regions, lateral hips, hip rotators and the pressure on the ITBand will decrease in almost all cases.  Every so often we find an ITBand that needs a corticosteroid injection but those are fairly rare as well.  We are not the biggest fans of ITBand release surgical procedures unless something other than running 5k’s is the causation to the problem, but again, every tool has it’s purpose and when properly used/applied it makes sense.  So getting past all of that, lets take a look at what we are working with here.

If you are familiar with our office, then you are familiar with the fact that we treat the Tensor Fasica Lata muscle on almost every runner and cyclist who comes to our office.  We also commonly treat gluteus medius, and sometimes gluteus maximus as well because the Iliotibialband itself is a fairly dense/tough piece of tissue that runs from the lateral border of the ilium down to the lateral border just below the knee and attaches to tibia, hence it’s name, the ITBand (Iliotibialband).

What a lot of patients don’t realize that now we are using SMART Tools as well for some “harder to deal with” cases of ITBand syndrome and this video from Smart Tools shows one very effective technique for mobilize the borders of the ITBand with motion.  As seen in the video below, this is just another way that we are ever expanding our use of manual medicine here at the office and not just relying on Chiropractic Manipulation, Active Release Technique, RockTape, Corrective Exercises, or SMART Tools IASTM (Instrument Assisted Soft Tissue Manipulation) to keep you, our patient, going and doing what you love!

Please note that if you ever need help from us about something giving you issues, please shoot us an email and will do our absolute best to get back to you in 24 hours or less!

Contact Us Page:  http://drmarkkemenoshandassociates.com/contact/

Need to see more pics of the Tensor Fascia Lata, Iliotibial Band, and Gluteus Medius you can trust, here is a cartoon version in a runner that is somewhat accurate.

Lastly, here are a few shots from our meeting at the Haddonfield Running Co a few weeks back where we talked running, problems like ITBand Pain, ITBand Tenderness, ITBand Tightness, and ITBand Syndrome.  In these pictures I the Active Release Techniques movements for treating the Tensor Fascia Lata and ITB!

 Contact Us Page:  http://drmarkkemenoshandassociates.com/contact/

Read More

Very nice summation of Chiropractic at Harvard Health’s website!

Up until last year the “Chiropractic” write up on Harvard Health’s website was very bland and vanilla.  It was more or less a very basic article.  At some point in 2016, they updated it and it truly aligns with the feelings of our office and how we approach our piece of medicine!

Article Link:  http://www.health.harvard.edu/pain/chiropractic-care-for-pain-relief?inf_contact_key=cd3df7fb1bc932636c26c98ec9f77b669326fbb8a84664eeb96b5eb28d57211b

Some VERY valuable outtakes from the article are:

“Most research on chiropractic has focused on spinal manipulation for back pain. Chiropractic treatment for many other problems—including other musculoskeletal pain, headaches, asthma, carpal tunnel syndrome, and fibromyalgia—has also been studied. A recent review concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain, and whiplash.”

AND…

“In addition, a chiropractor may advise you about changing your biomechanics and posture and suggest other treatments and techniques. The ultimate goal of chiropractic is to help relieve pain and help patients better manage their condition at home.”

Those two statements align extremely strongly with our views here at the office.  All of the associates here at the office, Dr. Andrew, Dr. Craig, and Dr. Tim found a great deal of ease working with Dr. Kemenosh because he always feels strongly that you treat the conditions we know we can help with and we refer out to other medical professionals whenever that is the best options for the patient!

If you are suffering with pain, and old sports injury, a relatively new sports injury, or some type of dysfunction in the body, we may be able to help!  If you have questions, you can always call our main line at 856-228.3100 or reach out to us on our CONTACT US PAGE BELOW!

Contact

 

Read More

Plantar Fasciitis: Active Release is truly a different type of attack for Plantar issues

So tell me what I need to know about Plantar Fasciitis:

Lately we are seeing a number of Plantar Fasciitis patients presenting to our office for ART (Active Release Technique).  Patients are finding out from word of mouth and from other doctors that ART is highly effective in treating stubborn foot issues like Plantar Fasciitis.  Plantar Fasciitis is usually the worst in the early morning and patients commonly report that they “have to prepare themselves for those first couple of steps”.  Heel pain that is true Plantar Fasciitis comes from inflammation of the thick, band like tissue that connects the heel bone of your foot to the toes.  This tissue is called the plantar fascia.  Patients then report that as the morning goes on and they stretch out their feet, that the heel and mid foot pain decrease to a point of being able to carry out a normal day.  Commonly the things that inflame plantar fasciitis are standing for long periods of time and getting up quickly from an office chair.  Runners are also susceptible to plantar related issues and shoe selection for this population can be key in its treatment.

Plantar Fasciitis most commonly causes a stabbing pain in the bottom of your foot.  Most commonly this pain is just in front of your heel bone, however can be in the middle of the foot as well.  The job of the fascia is to absorb shock and transfer force when standing and walking.  The plantar fascia is a very thick and strong structure that can become inflamed and over time will relay that inflammation to your brain through sensing pain and tightness in the foot.  The plantar fascia is also avascular for the most part, meaning it has very limited blood supply, which further complicates the tissue because it heals slowly.

What can you do?

Patients often benefit from making notes about what their symptoms are because often it’s hard to remember or describe what you are feeling once you are being examined.  Bring the shoes with you that you most commonly wear because often times, Plantar Fasciitis can be greatly affected by the shoes you wear normally or work out in.  Lastly, be sure to let your doctor know what medications and supplements you are taking.

Why is ART (Active Release Technique) treatment different from what most other medical professionals are using? 

ART therapy has specific techniques for the treatment of the Plantar Fascia, Flexor Digitorum Brevis, Quadratus Plantae, Flexor Hallucis Brevis, Abductor Hallucis, Abductor Digiti Minimi, Lumbricals and Flexor Digiti Minimi Brevis.  We mention all of those specific muscles and fascia because the foot is more complex than just “up, down and side to side”.  This is also why Plantar Fasciitis is a stubborn disorder to treat with just about any another tool or technique.

Secondary to all of those muscles of the foot, we also treat musculature and fascia above the foot which are connected via the posterior kinetic chain of the lower extremities.  These protocols include treatment of the Gastrocnemius, Plantaris, Soleus, Tendinous Arch of the Soleus, Popliteus, and well as other muscles if need be.  All of these muscles affect the tension placed on the Achilles tendon which then has an effect on the plantar fascia by pulling through the heel of the foot.  These muscles make up the back side of your calf, and are often tight to the touch and often overworked from wearing the wrong shoes or are the result of overuse injuries.

Using Active Release on the structures we have highlighted above, we seek to release tissues that are made of soft tissue (muscles, tendons, ligaments and nerves), and then treated dependent on if the tissue presents as a repetitive strains, adhesions, tissue hypoxia, and possible joint dysfunction.  If you have any questions about Plantar Fasciitis, please contact our office.  We feel that is it is almost a disservice to patients who fight Plantar issues for months with limited relief when a systematic attack is available backed by proven results.  ART providers like Dr. Kemenosh, Dr. Gross, Dr. Evans and Dr. Legath are always stating that whenever you search on Google for Plantar Fasciitis Treatment, the automatic answer should be Active Release Technique!

So, in a nutshell, how will ART benefit some with Plantar Fasciitis or just about any foot problem?

ART providers seek out the specific structures in the foot causing the Plantar Fascia to becoming stretched, irritated, or inflamed, and then treats not only the Plantar Fascia, but the soft tissues surrounding the foot, and more specifically, tissues that work in unison or are attached to the plantar tissues.  This technique more accurately “breaks up” the problem areas of the foot providing better healing you, the patient!

If you are not located in the Philadelphia or South Jersey area and need a certified ART provider, please look at http://www.activerelease.com/providerSearch.asp

Follow Dr. Kemenosh, Dr. Gross, Dr. Evans, or Dr. Legath on Facebook at http://www.Facebook.com/DrMarkKemenoshAndAssociates

 

Read More

Shin Splints are never fun, but at least ART can get you better quickly!

Dr. Kemenosh, Dr. Gross, Dr. Evans, and Dr. Legath treat a lot of runners in the South Jersey area for Shin Splints using Active Release Technique.  ART attacks shin splints differently than most other therapies and often yields better results.  The one thing Dr. Mark has built is a reputation with the local cross country teams on the best treatment possible for most foot, knee and leg aches and pains.

Before we get down to what we do for shin splints, we should discuss what shin splints actually are.  Most commonly, runners, dancers, and military recruits are diagnosed with shin splints, however, anyone can get them.  Medically speaking, medial tibial stress syndrome is the term used more commonly to determine shin splints, but anyone who has been a running club knows shin splints are bit more than just medial tibial pains, as they can also bite you on the posterior side of the tibia in some cases.  Patients often find that when they go untreated, pain can often then extend in the knee, ankle, or foot.  This is most commonly from your brain automatically trying to change your gait (running) pattern to stop pain in the shins.  So, overall, if you have shin splints, you may notice tenderness, soreness, or pain along the inner part of your lower leg.  You may also notice mild swelling in the leg, usually below the knee, but above the ankle.

So that you are aware, MOST cases of shin splints can be treated on your own!  Yes, we said, you can treat shin splints yourself, up to a certain point.  Some very helpful methods of home treatment including resting, ice, topical pain relief creams.  Some runners also intentionally seek out softer trails and find this helps to some degree, running on a mulch trail versus a concrete sidewalk can often make a small difference.  Another part of shin splints we find commonly are the shoes!  Worn out shoes or the wrong type of running shoes can often cause your shin splint and leg pain issues.  We will recommend our favorite shoe people at the end of this article.  Pain while running and exercising to a small degree can be considered normal in patients with shin splints, however if the pain levels rise to a point of being uncomfortable, unavoidable, or lingering longer than the run, you may need to seek medical help.

When is a good time to think about seeing Dr. Kemenosh and Associates about your shin splints or leg pains?

If rest, ice, and basic over the counter pain relievers are not helping your pains, it’s time to seek a medical professional.  If you have read along to this point, then you are probably rubbing your shins and thinking about what to do next.  Shin splints are most commonly caused by a repetitive stress of the muscles which anchor onto the shin bone (tibia).  The Active Release Technique employed by the doctors here at our office was specifically designed for treating repetitive stress injuries.  First, during your examination we will zero in on the structures which are truly injured and being over stressed.  Once these structures are identified, we will select ART Lower Extremity Protocols which will most commonly attack some of the following structures.  Tibialis Anterior is usually the key player in shin splints.  Tibialis Anterior is a very strong muscle that stabilizes and controls movement of the ankle and foot.  Often, runners who are just getting started for the season or are ramping up their mileage will overload the Tibialis Anterior muscle which can start to overload the periosteal attachment of the muscle onto the Tibia (shin bone).  Healing of attachments like these are often fairly slow and is an area that commonly is referred to as “less resilient” by most medical professionals.  Runners often try to run again, and the “less resilient” area refuses to lengthen properly during the running motion, as it is still in a state of healing and fibrosis of the structures further shortens the tissue.  The results of this cycle is increased pain with running, and all of it is related to overuse with proper attention to treatment.  If it helps, the muscle should work like a rubber band to help absorb force during running, but instead acts like a tight rope which has no give.

We also do not simply blame the Tibialis Anterior muscle, we also commonly find fibrotic spots of tissue in the Extensor Hallucis Longus and Extensor Digitorum Longus.  Outside of these three main structures, we also commonly treat the Gastrocnemius and Soleus muscles of the posterior compartment which are the muscles that make up your calves.

The muscle that is not commonly treated by other medical professionals when working on shin splints is the Tibialis Posterior.  The “Tib Post” as we like to call it around the office is often the muscle that patients don’t like us to treat while they are experiencing running/exercising related shin pain issues.  So why do we work on the Tib Post muscle, it is a very strong and deepest central muscle in the calf.  Because it is rarely truly treated on patients with shin splints, you are simply buffing the exterior of the car without cleaning out the exterior.  With proper treatment of this muscle, as well as the muscles listed above, we seek to break down fibrotic tissue using specific, strong contacts with active motion and this again allows your muscle to function as a rubber band, lengthening and shortening normally, and less like a rope.

Please note that in some cases, imaging can be necessary to rule out the possibility of a stress fracture and stress reactions.  In treating some cases of shin splints, we also watch out for a possible issue related to extensive degradation of the structures known as compartment syndrome, which while rare, is something we always keep on the possible differential diagnosis.

So, if you are having shin pain, shin splints aka Medial Tibial Stress Syndrome with activity and would like to give the team at Dr Mark Kemenosh and Associates to examine and treat you, please call us today!  856-228-3100

If you are not located in the Philadelphia or South Jersey area and need a certified ART provider, please look at http://www.activerelease.com/providerSearch.asp

Follow Dr. Kemenosh and Dr. Gross on Facebook at http://www.facebook.com/DrMarkKemenoshandAssociates

If you are feeling that your shoes are a serious problem, do not just trust a big box running shoe store to get you fitted properly if you are running in pain.  The two stores that we work extensively with are:

Dave at the Haddonfield Running Co. on Facebook at https://www.facebook.com/pages/Running-Co-of-Haddonfield-Moorestown-Mullica-Hill/113718775305658?ref=ts&fref=ts

-OR-

Moe at The Sneaker Shop of Ocean City on Facebook at https://www.facebook.com/thesneakershop.ocnj?fref=ts

Read More

Research Round Up: Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries: An Association Which Varies According to Type of Injury

Wow, what a study!  I’m sure we all are reading the running journals coming out of Denmark, but in case you missed it, a study was published this past month in the Journal of Orthopaedic & Sports Physical Therapy, Volume 44, Number 10, October 2014.  The title of the study was Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries:  An Association Which Varies According to Type of Injury.  The study itself was an explorative, 1 year prospective cohort study.

To save our readers and patient’s time, we will only skim over the high points of the study.  The overall sample size was 874 healthy novice runners who started just about any type of running program.  The reason for the study is because it is widely accepted that a sudden or drastic increase in running distance is strongly related to injury in runners, however the scientific knowledge used to support this knowledge is somewhat anecdotal and lacks a strong statistical analysis to support those findings.

The runners in the study were supplied with a GPS (Global Positioning System) watch.  They used to track when the runners made large increases in distances ran.  During the study, a total of 202 runners sustained a running related injury.  They researchers noted an increase in the following conditions:  Patellofemoral pain, Iliotibial Band Syndrome (ITB Syndrome), Medial Tibial Stress Syndrome (Shin Splits ARGH!), Glut Medius Injury, Greater Trochanteric Bursitis (Hip Bursitis), unspecificed injury to the tensor fascia latae (ITBand Syndrome, the TFL is the muscle which pulls on the ITBand), and Patellar Tendonopathy.  The researchers noted that injuries like those above occurred existed in RUNNERS WHO INCREASED THEIR DISTANCE BY MORE THAN 30% COMPARED WITH THOSE WHO PROGRESSED LESS THAN 10%.  These results had a confidence interval of .96 which means there is a good deal of significance when tested statically.

So, how does this affect me?  Do I even care about this study?  Well, if you are runner, yes you should!

The study proved that NOVICE (First year runners) who progressed their running distance by more than 30% over a 2 week period seem to be more vulnerable to a distance-related running injury.  This is when compared to runners to who only increased their distance by 10% over a two week period.  Please note that the researchers and authors admit that this was more of an explorative study and that an RCT (Randomized Clinical Trial) needs to be done to validate the assumptions made in this article.

So, Dr. Kemenosh and Associates, what are you trying to tell me about running in regards to this study?  Should I stop running?

Absolutely not!  The study validates to some extent that old adage of “slow and steady wins the race” when it comes to running and training.  We hear novice runners asking us all the time about “running hacks, life hacking, and marathon hacking” and while those systems have helped changed traditional marathon training, we still need to look into issues commonly caused by running too much, too hard, too soon.  The take away here is that true novice runners should be advised to progress their weekly distances by less than 30% per week over a two week period, to avoid the types injuries I listed above (which are all very common in runners).

Looking for help with muscle and tendon related issues?  Hamstring, calf pain?  Sore shoulders or low back pain?  Those are the things we most commonly work on here at the office!  Give us a call – 856-228-3100

Read More