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: Piriformis Syndrome

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

ESPN Outside The Lines – Quality Of Care – Back Pain Strikes Down two Indiana University Athletes

While I was on the treadmill and working out yesterday at the gym ESPN’s investigative reporting journal, Outside The Lines, came on and showed a very interesting story (to a chiropractor who works on a good deal of young athletes at least).  The story started about the mismanagement and treatment of several young athletes at the Indiana University who developed a great deal of mid, low back and hip pain.  Two in particular had striking stories about the misdiagnosis of back pain that was very serious and one had to have a fairly serious surgery that might very well have been corrected using conservative measures if they were properly diagnosed and treated in the first place.  In the case of the football player, it seemed to some extent that he was “machoed” into continuing to suit up by the coaching staff. The simple fact is this, if you can barely walk across campus, you probably can’t withstand football practice.  If you are an athlete or the parent of an athlete, you should probably check out this podcast or look for a re-run of the episode on ESPN because it was saddening and informative about what happens when athletes quite simply push themselves too far.  While it was tough to say who is truly at fault, it was a poor choice of the coaches and trainers at the university who let these issues spiral out of control.

If you are in a situation where you are simply being told to rub some dirt on it and to play and something truly feels off, please seek outside medical care from a qualified healthcare practitioner.  In both of the cases shown in this article, it took far too long for the true problem to be identified, diagnosed and the proper treatment protocols activated.

Podcast Teaser: Indiana football coach Kevin Wilson lost his job in December and reports surfaced of players alleging medical care had been neglected. Our 3-month investigation found more.

Podcast Link: http://www.espn.com/espnradio/play?id=19223941

 

Struggling with a sports related injury?  Please give us a call at 856-228-3100 to see if we can help.

If email is easier, hit us up on our contact us page linked below!

 

Contact

Read More

Jake Arrieta’s Full-Body Pilates Workout and a bunch of NFL players who take Authentic Pilates lessons as well!

The Chicago Cubs pitcher transformed from a struggling young pitcher to Cy Young winner by doing this routine.  Strong statement we know, but that comes directly from Muscle and Fitness magazine!  Lets look a little closer however at the stats leading up to Jake Arrieta doing Authentic Pilates.

Directly from the article:  “Before discovering Pilates, Arrieta, 30, had never won more than 10 games in a season. So it’s fair to say that Pilates helped kick-start the Texas native’s career. However, a dedication to functional range conditioning, weight training, cardio training, massage therapy, and a healthy diet relying heavily on pregame smoothies didn’t hold him back, either.”

Link:  http://www.muscleandfitness.com/features/edge/jake-arrietas-full-body-pilates-workout

With the addition of Jill Kemenosh we hope to have Authentic Pilates and ELDOA Method lessons running very soon at the office!

Need even more reasons to try out Pilates and get your core right?  Check out the link below!

Link:  http://drmarkkemenoshandassociates.com/antonio-brown-martellus-bennett-brandin-cooks-michael-campanaro-chris-givens-common/

Antonio Brown, Hunter Pence, Matt Forte, Brandon Marshall, Martellus Bennett, Brandin Cooks, Michael Campanaro, and Chris Givens all regularly do Pilates and we have some video to prove it!

If you are looking for a Pilates instructor, give our office a call!

Read More

Jill Kemenosh is now Level I and II certified in the Eldoa Method!

Dr. Mark was introduced to the Eldoa Method last fall at the TPI World Golf Classic and saw a great deal of refinement in the way they handled back related discomfort and pain when integrating exercises and stabilization movements into the mix.  Once getting back and sharing some of the short videos he took at the seminar, his daughter Jill, a certified Pilates instructor took immediate interest since she has such close relationships with 5 chiropractors!

So what is the the Eldoa Method?  The ELDOA exercises and Myofascial Stretches are specific techniques created by world renowned osteopath, Guy VOYER DO. ELDOA METHOD Classes are semi private group classes organized by certified instructors.  To see our last post about Dr. Mark and Jill taking the Eldoa part 1 certification courses last month, see the link below!

http://drmarkkemenoshandassociates.com/dr-mark-kemenosh-eldoa-method-colorado-seminar-past-weekend/

Without warning, and without Dr. Mark, Jill pressed on to part II of the Eldoa certification this month.  The mix at Eldoa certification seminars ranges from Pilates and Yoga instructors all the way up to Physical Therapists and Chiropractors, which for the most part are the practitioners who deal most with back pain of all sorts.

BENEFITS OF ELDOA METHOD Classes and Instruction 

ELDOAs and Myofascial Stretches are very specific and complex techniques that require strong attention to form and correct progressions. Everyone will benefit from the effects of ELDOAs and MFS but each person is different and without proper instruction and help from a Certified ELDOA/MFS Instructor, these techniques will not be as effective. By attending the classes, you not only receive instruction from a certified instructor but the full hour dedicated to stretching enhances the many benefits including:

  • Normalize Disc Bulges
  • Reduced Degrees of Scoliosis
  • Increased Flexibility
  • Improved Muscle Performance and Tone
  • Normalization of Visceral Function
  • Reduced Stress
  • Injury Recovery and Prevention
  • Reduced Joint Inflammation and Arthrosis
  • Delayed Disc Degeneration
  • Increased Disc Hydration
  • Increased Blood Flow
  • Improved Posture
  • Relief of Chronic and Acute Back Pain
  • Relief of Neck and Shoulder Tension
  • Improved Awareness and Overall Wellbeing
  • Improved Recovery Time for Sports and Training
  • Reduced Forward Head Posture

Definition:  The ELDOA are postural exercises (LOADS) that you can do yourself with the primary goal being to increase the space within a chosen articulation. As the ELDOA “create” space, there is an improvement in joint mechanics, increased blood flow, reduced pressure on the discs, a reduction of pain, spinal disc rehydration, better muscle tone, improved posture, and a sense of well being and awareness.

The human spine is a complicated and vital structure. Compression and articular blocks can cause pain, arthritis and neurological conditions. The ELDOA exercises are a highly effective solution to these conditions. The ELDOA are very precise postures that target a specific joint region to provide relief from pain and restore balance. LOADS (Longitudinal Osteo-articular Decoaptation Stretches) are postural self-normalizing techniques, which aim at widening the space within a pair of joints. It is possible in one minute a day to relieve disc compression between L5-S1 or even more specifically at the base of the long arm of the left sacroiliac joint.

The coolest part of the seminars are that portions of the classes are taught right outside of the Super Dome in New  Orleans!  Check out these pictures and more from Jill’s second round of certifications in the ELDOA Method.

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

How come your office works so well with other doctors? We were trained this way!

One of the hallmark reasons most of the associates here at Dr. Mark Kemenosh and Associates are excited to work on this team is because we do our best to adhere to the mantra of “do best by the patient”.  As you can see on this article from our alma mater, the National University of Health Sciences further down, one of the fundamental lessons we learned was to treat the conditions you can treat and to refer out, ask for help, or even further research who can help the occasional issue we run into here at the offices.

At NUHS in Chicago, we had a pathologist on staff who was an MD and often times another MD and DO who floated around our clinic a few days each week.  This helped introduce us to many different treatments and helped us to always remember that the answer may not always be purely Chiropractic oriented.  We know that the future of better patient care is integrated healthcare and we do our best to help that process along at this office.

Just recently I received an email that a new MD would be helping out at our whole health clinic in Lombard, IL, please see the title and link below!

NUHS Whole Health Center welcomes Asad Zaman, M.D., to its clinical staff

Link:  http://www.nuhs.edu/news/2016/12/whole-health-center-welcomes-asad-zaman,-md,-to-its-clinical-staff/

So when you look around our website and notice that often times our office is sent referrals from pediatricians, orthopedics, family practice doctors, and many more, you can rest assured that we have earned the trust and respect of many in our field.

If you have questions or need help with issues that are holding you back, please give our office a call at 856-228-3100 or fill out a contact us request at the link 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

Dr Mark Kemenosh Seminar Recap – Guy Voyer, DO – Joint Pumping – Articular Pumping

While at the Titlest Performance Institute World Golf Fitness Summit a few weeks ago, Dr. Mark Kemenosh was introduced to Guy Voyer and Dan Hellman who were teaching an elective course on techniques they have been developing for several years now.  Who is Guy Voyer, DO?  Check out the link below!

About Guy Voyer, DO

This past weekend Dr. Mark was in Fort Lauderdale, Florida for a follow up seminar on articular pumping or more commonly referred to as joint pumping.  Dan Hellman refers to the techniques below in an excerpt taken from his website.

Structures That Need Pumping?

What is articular pumping?  The first thing we need to define is what is an articulation.  An articulation is a “joint” that is usually formed of fibrous connective tissue and cartilage.  There are many types of joints and they are usually grouped according to their motion.  Joints are often subject to arthritis, capsulitis, arthroses, traumas, sprains, strains and tendinitises.  The same way a cylinder slides inside a piston and requires oil, the proper functioning of joint calls for synovial fluid.  The body also contains little “sponge like” structures called bursa.  When the bursa is well hydrated, they prevent friction between tendons and ligaments acting like tiny shock absorbers.

What Is Pumping?

For all the reasons listed above, the joint fluids must be mobilized with a gentle technique called articular pumping.  With this in mind, there is a very precise method of targeting a ligament, tendon or joint capsule with over 600 precise pumping techniques.  Pumping of the joints is like taking your car in for a “grease job” to lubricate all the joints.  The technique feels amazing and the results are dramatic.

– See more at: http://hellmanholistichealth.com/blog/1363/time-get-pumped/#sthash.1LnPImVE.dpuf

Here are some pictures of Dr. Mark’s adventures this past weekend at the seminar.

Dr Mark looks forward to integrating some articular pumping techniques into our routine of Chiropractic and Active Release treatments here at the office.  If you are in need of joint or muscle related pain in South Jersey or Philly, give our front desk a call at 856-228-3100.  

 

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

Up late, but always thinking, possibly dreaming, about running, so I did a search about the Hoka One One’s…

REPOST:  This blog was originally posted on 10/07/2014!

I should probably be sleeping, but with all these local cross country runners from all over South Jersey and Philly coming in for Active Release treatment and performance tune ups, I just can’t help myself from reading and researching about running.  While I was searching, I found a blog, written by Podiatrists talking about the HokaOneOne shoes and I just could not help myself from reading.

The blog itself can be found here:  http://www.podiatrytoday.com/blogged/hoka-one-one-marketing-hype-or-another-running-shoe-revolution

The last line of the blog is the actual reason that I stumbled onto this blog, because it mentions “sesamoiditis” which is something that my wife suffers from and we can treat very well conservatively using Active Release Technique, however, but the mileage per week for marathon training goes above about forty miles per week, her feet slowly start to fight back.  Currently we are starting to explore possibly having the sesamoid bone surgically removed or if possibly a pair of “maximalist” shoes could benefit her long range training marathons.

The last paragraph from the Podiatry Today blog states:

Fortunately, I am not seeing the injuries with Hoka One One that I saw with FiveFingers. However, similar to FiveFingers, maximalist cushioning isn’t going to benefit every runner’s foot type or heel strike. Also, not every model is designed for the same foot or supports the foot the same way. My favorite Hoka One One model is the Bondi as it hourglasses the least in the waist of the shoe. If the fit is correct (width, depth, etc.), I have prescribed Hoka One One for runners experiencing sesamoiditis and hallux limitus/rigidus as the shoe may be beneficial for those conditions.

With Dr. Kemenosh feeling pretty good about running in his Hoka One One Bondi 3’s after years of avoiding hard surfaces, we may possibly be picking up a second set of Hoka’s in the Dr Mark Kemenosh and Associates running stables.  We will keep you posted on how things go down because Dr. Mark is actually meeting with Hoka’s rep at the Sneaker Shop in Ocean City tomorrow night.  Stay tuned runners!

Wondering about where you can find the Ocean City Sneaker Shop?

Google Maps – Ocean City Sneaker Shop Link

Wondering what all the hype is about with the HokaOneOne running shoes?

HokaOneOne Technology and Info Link

the-winner-hokaoneone-infinite dr-craig-evans-hoka-clifton-3-pic-1 dr-craig-evans-hokaoneone-bondi-heel-spurs-1 dr-craig-evans-hokaoneone-bondi-heel-spurs-5

Read More