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

All Posts in Category: Plantar Fasciitis

Common causes of foot pain – plantar heel pain versus plantar fasciitis

Plantar Heel Pain – soreness or tenderness of the heel that has a location restricted to the UNDERSIDE (heel pad) of the heel bone. Pain often times radiates from the central part of the heel pad towards the BACK OF THE HEEL itself…


Plantar Fasciitis – involves inflammation of the thick band of tissue (THE PLANTAR FASCIA) that runs across the bottom of your foot from the heel bone to your toes. Pain usually starts in the front of the heel bone and feels like it travels through the plantar fascia towards the toes.

Heel pain, plantar fasciitis, plantar heel pain, usually respond well to Active Release Technique and IASTM at our office!

The Bad News: It sucks and it hurts, usually causing us to limp.

The Good News: We treat them both and know when to ask for HELP if need be!

Struggling with either issue, give us a call 856.228.3100 or EMAIL US ON OUR CONTACT US PAGE below!


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Ice or Heat for Injuries – Is the medical standard changing

A very interesting article appeared over at 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 —

“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



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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


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


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


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


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!


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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!


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


  • 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?




Need more info?  Ready to register?


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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!



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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:

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.  


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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

Follow Dr. Kemenosh, Dr. Gross, Dr. Evans, or Dr. Legath on Facebook at


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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

Follow Dr. Kemenosh and Dr. Gross on Facebook at

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


Moe at The Sneaker Shop of Ocean City on Facebook at

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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:

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

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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

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