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All Posts in Category: Core Strength

Lower Back Injury and what you can do!

Every year thousands of people suffer some type of lower back injury. This often requires a visit to their chiropractor as a result of gardening or doing some other type of yard work. This happens a lot in the spring when people are anxious to get outside and tend to their yards after months of being penned indoors by the winter season.

It is relatively easy to injure your back, especially if you are moving heavy objects around the yard. While good chiropractic care is always one of the first things you should do after receiving such an injury, you also want to consider the fact that chiropractic care, which occurs on a fairly regular basis, may help to curb some of these injuries in the first place as does following some common safety precautions when you are working in your yard. Our team can help you improve your readiness for the spring season using Active Release Technique, Chiropractic Manipulation, home exercise strategies, and improving your stretching at home as well!

There are a number of tips that can help you when it comes to preventing back injuries while you are working in your yard. Perhaps one of the most important things to remember is that in most cases, the more fit you are the less likely you are to suffer an injury of this type. Fitness is a good idea in any case and this is especially true when you are performing any type of rigorous physical activity. Good muscle tone and flexibility will go a long way toward helping you stay healthy and free from back injuries that can be very painful.

In addition, you always want to lift properly. Always lift with your knees and keep your feet in front of you approximately a shoulder length apart or even slightly wider. Whatever you do, always avoid lifting with your back. This is one of the primary reasons that people receive back injuries in the first place. Another thing you can do to reduce your chances of injuring your back is to use tools that work well for you. If you are an individual with a smaller build, you need to use smaller tools and try not to move things that are too heavy without help.

Of course, if you do feel tightness in your back, or you have had an especially hard day, you can typically relieve much of the tension by icing the muscles appropriately. If you prefer, you may want to alternate ice and heat in order to reduce inflammation and then relax the muscles. Ensure that you do not apply ice directly to the skin and that you use caution when applying heat as well.

It is always a good idea to visit your chiropractor on a regular basis even if you are not currently experiencing any problems. Professional golfers in particular have recently shown that they stay in top shape with semi regular visits to the chiropractor. This can prevent you from suffering a back injury or some other type of injury while you are working in your yard.

In the event that you do suffer an injury our team would be more than happy to help and can be an integral part of the recovery process. Working in your yard and getting ready for spring is something that most people enjoy, but it is also something that you should do carefully in order to ensure that you do not injure yourself. Be safe and contact us with any questions you may have.

If you have questions, please use our CONTACT US page at the following link!

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Dr Craig’s favorite prehabilitation exercise – Monster Walk with Theraband

I teach this exact exercise several times a day as well as a few variations almost on the daily since the basis of most of our patients are runners.  This exercise can never be done slowly enough, anyone can do this movement quickly but slow down and act like you have a hot cup of coffee in your hands.  Almost everyone does these exercises quickly and while there is nothing wrong with that, slower is almost always better.  Check out all the following videos on how to practice this excellent prehab movement for most runners struggling with “typical runner stuff”.

If you are a South Jersey runner struggling with pain and tenderness as we lead up to the big part of summer running season which is just ahead (Broad Street Run, Philly Rock N Roll Half, Chicago Marathon, Philly Half and Philly Marathon are all on the horizon) give us a call at 856.228.3100.

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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:

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:

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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:

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.”


“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!



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CNN Article – Here’s why you exercise so much and still can’t lose weight

We see a lot of runners in our office, as in A LOT OF RUNNERS, and we very proud of that niche!  We are the ones that occasionally have to tell them to stop running for a bit (which is always great fun… … …).  This article resurfaces every so often and is very important read for runners.  The article touches on the fact that often times even if you ramp up your mileage in training, you won’t necessarily loose more weight due to running.

Please note all credit for this article is given to Carina Storrs, a author.  The full link to her article is below.

Some key points from the article state:  

The study is in step with a growing body of research suggesting that burning a bunch of calories is a less realistic weight loss strategy than we might have thought, or hoped. “We can’t push the calories out [value] around too much,” Pontzer said. “Our bodies work very hard to keep it the same.”

It might be time to shift that standard public health message: To lose weight, simply exercise more. “We would say that ‘If you want to lose weight, you probably ought to focus on changing your diet and watching how much you eat.’ Exercise can help and it’s really important [for health in general], but they are two different tools,” Pontzer said.

The challenge of trying to lose weight just by exercising more is no secret to some clinicians. “This study actually explains a phenomenon that I see quite commonly,” said Dr. Holly F. Lofton, director of the Medical Weight Management Program at NYU Langone Medical Center.

“I see patients training for a marathon and they ask me, ‘Why am I not losing weight?’ ” even though they are exercising more and eating the same number of calories, Lofton said.

“If you run all the time, try biking or swimming, and if you bike, try running or swimming, because using different muscles can increase your energy expenditure again,” Lofton said. “It may also be possible to decrease and then increase your activity again and get an increase [in calorie burning],” she said.

And if you think you can necessarily rely on your Fitbit or other device to tell you how many calories you burned, think again: We probably burn proportionally fewer calories as we exercise above a certain level of intensity.

I highly feel that you should read the entire article on at the following link:

The overall point of this article is just this, if you are runner who is putting in a reasonable amount of miles weekly and still struggling with weight loss or injuries from too much running, you need to re-evaluate your plan from the top down.  Runners can almost always benefit from swimming, hiking, cycling, strength training, core stability and a HEALTHIER DIET.  There I said it, it had to be said and I said it.  As a runner myself, I once thought that running a good deal (usually around 25 miles per week or more depending on the training cycle) would allow me to eat and drink whatever I wanted.  Simply put, after many years of struggling with my diet, chiropractic somewhat put me on the track to greatly improving my diet as well as figuring out how to make meals healthier.  If you need help with running injuries, diet recommendations, and some cross training recommendations, give our office a call, 856-228-3100.


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Cross Country season is over and one of our biggest battles is preventing stress fractures in the fall!

We see a great deal of endurance athletes at Dr Mark Kemenosh and Associates, which range from runners to cyclists, to swimmers, as well as putting them all together in the form of triathlons.  We have truly started to pride ourselves in being the doctor’s office that most endurance athletes in the area turn to for treatment and advice.  With cross country season being in full swing now this far into the fall, we are starting to see an uptick in stress fracture related cases.

The Mayo Clinic’s online definition of stress fractures is stated as:

Stress fractures are tiny cracks in a bone. Stress fractures are caused by the repetitive application of force, often by overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of a bone that’s been weakened by a condition such as osteoporosis.

Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Track and field athletes are particularly susceptible to stress fractures, but anyone can experience a stress fracture. If you’re starting a new exercise program, for example, you may be at risk if you do too much too soon.


While starting to research this blog post, I couldn’t help but notice a great article written by Thomas C. Michaud, D.C. and published in Competitor Magazine on February 11th, 2014.  Dr. Michaud stated (with references) that in the United States, one in five runners will sustain a stress fracture which means the US running population creates around 2 million stress fractures per year.  Dr. Michaud references a very good study done by Matheson which evaluated 320 athletes with stress fractures.  69% of the population in that study identified themselves as runners, while only 4% were from basketball, 5% from tennis, and 8% related to aerobics class, as the initial cause of injury.  Does this mean that running is bad for you?  No, but you may want to look at my earlier blog posts about running too far, too fast, and the relationships between injury in runners who ramp up their training too quickly.


What was extremely AWESOME about DR. Michaud’s article is that he pointed out that while stress fractures are indeed related to impact forces, that rarely we consider muscle strength as a very important prevention factor when discussing stress fractures.  Dr. Michaud’s thoughts were that:

In many cases, stress fractures are not the result of weak bones cracking when exposed to excessive stress, they are the result of various biomechanical factors in which healthy bones break down when exposed to otherwise manageable impact forces. Though rarely considered, muscle strength plays an important role in the prevention of stress fractures. In an interesting study of muscle volume and the development of stress fractures, researchers from Australia (3) determined that a 10-millimeter reduction in calf circumference was associated with a fourfold increase in the incidence of tibial stress fracture.


So if you are feeling recurrent pain in your legs, and you think a stress fracture could be in play, when should you see a doctor? 

You should contact a doctor if the pain becomes severe or persists even at rest.  Stress fractures are most often caused by the repetitive application of a greater amount of force than the bones of your feet and lower legs normally bear.  Bones are alive, we rarely think of them of being alive, but they are constantly growing and resorbing.  Bone growth and resorption is a constant process which goes on night and day, never stops.  When we exercise and put weight through our skeletal system, it gets denser, meaning the bones actually get stronger.  A stress fracture is most often caused by forces increasing into the bones without the ability of the bones getting denser.  In a nut shell, repetitive force into the bones causes turnover of bone cells, but you actually do this while your rest.  So recovery times are key during any time that a stress fracture is present.

Before coming to see a doctor, the following things are great to be ready to tell us.

What activity makes your symptoms better worse?  What other types of medical problems do you have?  If you are female, are you having regular menstrual periods?  What types of medicines and supplements do you take regularly?  What type of sports are you involved in?  Are you still able to practice or compete in those sports?  Who else have you seen for this injury, if anyone?  Have you had any imaging recently for this complaint?

Commonly, depending on your symptoms, the doctor may treat you right away or have you sent for diagnostic imaging.

In most cases, x-rays will be ordered when looking for stress fractures.  With that said, it is important to understand that often times stress fractures are not apparent on x-rays.  It may take a few weeks for stress fractures to show up clearly on x-ray.

MRI is the best tool that we have for detecting stress fractures as MRI can detect areas of inflammation noted as an early stress response.  MRI has the best ability to detect a stress fracture within the first week of injury.  So, in cases with severe unrelenting pain, the MRI allows the doctor to be able to see changes in both bone and soft tissue.

Treatments are variable when it comes to stress fractures depending on the severity and pain response, but here are a few treatments available.

Rest:  Decreasing the bones weight bearing load until healing occurs is often the most important first step to keep a stress fracture from being let go until a full blown fracture starts to form.  Some patients will need to be taken off weight bearing activities while others may be still permitted to walk around lightly.  Another important factor is SLEEP!  For your bones to properly heal, you actually need to get some sleep at night!

Ice:  Ice may or may be prescribed and is dependent on the amount of time since you feel the stress fracture occurred.  Ice can often reduce swelling and relieve pain, however after the initial acute symptoms, ice can often be contraindicated as it can slow healing factors.

Resume Activity:  Once your doctor allows you to resume activities, it may seem like common sense, but you will need to return to activities slowly to stop the possibility of a recurrence.  Activities like running need to be rolled back into SLOWLY, as even after the bone heals, it will still need to adapt to the loads present.  Running on softer surfaces and possible changes in footwear are a great idea to be evaluated.

What can I do to prevent a stress fracture?

In a previous blog post, we discussed a research paper that loosely proved that novice runners who increase their weekly marathon distances by less than 20% each week were very much LESS LIKELY to have an injury versus those who increased their weekly distance by 30% or more.  This study somewhat proves the old adage that “slow and steady wins the race”.  So the take home message here is make changes slowly to any new exercise program.  Set manageable goals and work your way up slowly and move progress along gradually.

Footwear can be huge in preventing stress fractures in the lower body.  Often it seems like common sense, but we forgot that most running shoe companies test their shoes to be effective at shock absorbing for a certain amount of miles.  Shoe fit is also very important.  Some runners can run in anything and not get injured, while others may need a custom fit orthotic.  Runners with high arches will most likely need to select a running shoe built to support height of the arch.  Dr. Kemenosh and our friends at the Running Co. of Haddonfield and Moorestown are both sneaker fanatics who can greatly aid you in a search for the right shoe.

Often times, endurance athletes who get higher into the mileage find that cross training is needed to keep up a high level of exercise that their overall output demands.  You can add lower impact activities to your work outs like swimming, biking, and weight training.  Weight training is often passed over by running athletes and as stated above, an Australian study has loosely proven that muscular strength helps to lower the possibility of stress fractures.

Nutrition, wow, we could actually write another blog post on nutrition alone and to stop from going into all sorts of nutrition information we will simply say that you need to eat well to keep your body healthy.  Often times around our office we like to say, “you don’t put cheap gas in a race car”.

If you or anyone you know is suffering from a common running problem like stress fractures, feel free to reach out to Dr. Kemenosh, Dr. Gross, Dr. Evans, or Dr. Legath at 856-228-3100.  Please note that the information above is strictly information and should be treated as such.  Dr Mark Kemenosh and Associates cannot and will not be held accountable for the information above being misused.  If you come to our office, we always do an examination so we get to the bottom of your specific problem.  

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Runners Butt (aka Weak Glutes): Don’t worry, it can be fixed

Great article on discussing a common running related problem that we always try to sure up in our running community.  The tag line for the article was “Don’t get left behind—strengthen your glutes!”  This is a very fitting statement because weak glutes causes other muscles in the system to fatigue over time which can lead to a repetitive stress injury.  The glutes may not be the most important muscle when running (and walking and climbing stairs for that matter), when compared to something like the heart, but they are very instrumental in how you move.  The article at can be found at:

The article is authored by Matt Fitzgerald who can be followed at:

Matt has written some other great pieces linked to the page above.

Now diving into these glutes, we have to understand that when we say the glutes, we are actually talking about three muscles, not just one, with fibers that run different directions.  The gluteal muscles help connect the low back to the pelvis and to the lower extremities.  A strong glute complex is very important to hip stability.  The big part of your butt that you can easily reach back and poke is the Gluteus Maximus, this muscle runs from the back side of the pelvis and attaches on the femur.  The Glut Max has to work in close proximity to the iliotibial band which is another issue runners commonly experience. To add complication to this system, the posterior portion of the Gluteus Medius is covered by the Gluteus Maximus.  The Glut Med as we like to call it is a prime stabilizer of the hip that when it becomes weak, allows the hip to drop opposite from the stance leg.  Back in the day, before vehicles were super accessible, well actually before vehicles even, oh yeah, we are taking it way back here.  So lets say previous to the 20th centry, people had to use their gluteal muscles more.  People walked long distances commonly, lifted and carried heavy things and since elevators did not exist, we humans climbed a lot of steps which really keeps those glutes strong.  When the glutes become weakened, they allow for over pressure and overwork to start happening on the smaller muscles of the pelvis.  When this happens, muscles that are commonly not supposed to be major players in our gross movement patterns start to be overworked, muscles like the piriformis, the TFL (Tensor Fascia Late which controls the ITBand), the quadratis femoris, as well as other small muscles.  In runners, we often hear “if only I could get my piriformis to stretch…” and in all likelihood, the piriformis needs a stronger glute complex to help it control the motion of the femurs and pelvis.  If issues related to the pelvis are commonly left go for too long, the dysfunctions will then start to transfer into the lumbar spine (low back area) or possible translate into the knees.

Runners Butt 101 – Gluteus Maximus vs. Gluteus Medius

If you have noticed on news channels and social media alike, the current themes are things like “SITTING IS THE NEW CANCER”, “SITTING IS THE NEW SMOKING”, “IS SITTING TOO MUCH KILLING YOU SLOWLY”.  While this certainly is a problem, sitting too much can cause atrophy of the gluteal regions, the good news is that we can strengthen the glutes and get you back together quicker than potentially someone who has smoked for a long time.

The take home story in all of this is we need to keep moving, sit on our butts less, and always try to include an exercise that helps strengthen the glutes and its supporting cast into our workout plans.  If you feel issues like this are possibly contributing to your problems while running, low back pain, butt pain, or leg related problems, you should come and see us for an appointment sooner than later!  If you wondering what the answer is, it involves all kinds of fine exercises like Squats, Squats, and possibly more Squats!  We also have some other sneaky corrective exercises that help get our runners back into peak form, but you will have to wait for another article to get all of that or you can come see us!

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We got a shout out recently and you can bet we are going to let the world know!

Our good friend and patient recently gave us a shout out on her blog where she discusses all of the most important things in South Jersey, at least as they apply to her.  The blogger goes by the name FueledByLOLZ and we treated a few “pain in the butt” issues she had earlier this year and so far she has put herself back on track for some personal goals like running a sub 19 minute 5k race again.

You can find her blog at the following link:

Aside from working at the Haddonfield Running Co, some of Hollie’s PR’s include, a 1 mile PR of 5:31, a 5k PR of 18:35, a 10k PR of 39.04, a 10 mile PR of 1:03:10, a half marathon PR of 1:23:23, and a full marathon PR of 3:15:23, all of which are very impressive!  Give her blog a read when you have some time and prepare to be educated on New Jersey Diners, some fun local races, Coffee, and a lot of running related topics like running fashion, running training, and race preparation!


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What do Antonio Brown, Martellus Bennett, Brandin Cooks, Michael Campanaro & Chris Givens all have in common?

With a few moments to myself this morning as well as the NFL playoffs coming up this weekend, and my team just barely sneaking into the playoffs, I looked to an older article over at which featured some of the NFL stars who do Pilates!  You might have heard that Lynn Swan and John Stallworth did ballet and yoga to help them improve their legendary football abilities in the 1970’s, but now we are seeing more and more athletes turning to Pilates.  I myself, Dr. Craig Evans, was unfamiliar about Pilates other than a few times in Chiropractic school I was invited to floor based Pilates classes and rarely went (huge mistake, let my ego cloud my judgement) and then after meeting Dr. Kemenosh, I noticed that he almost religiously does a Pilates workout at Lisa Gadsby’s studio in Philly or at our own office, one to two times per week.  He mixes in Pilates, running, and swimming for the most part.  Take a peek at the article on Stack, which features a great video of Antonio Brown working out PHI Pilates.

One of the best statements of all about Pilates is from the Chicago Bears own, Martellus Bennett, who states below on the Stack article:

In an interview with Pilates Style, Bennett, a tight end, noted that the demands of his position take a toll on his joints and his lower back. After his first session, Bennett was hooked, and now he does Pilates up to five times a week. He said, “I can lift 500 pounds, but in a Pilates session, there’s always some different type of motion that’s hard for me to do. That’s what is so great about it.”

Now being around the office and with the ability to use some of Dr. Mark’s equipment, I can truthfully say that after being trained for fun by Dr. Mark’s daughter Jill Kemenosh, some of the movements are harder than I ever imagined you could make body weight exercises.

Noted Links:

Stack Article on NFL Players who do Pilates:

Evolving Pilates of Philadelphia – Lisa Gadsby –

Antonio Brown credits Pilates for his footwork:

In the link above over at stack above, Antonio Brown credits his Pilates workouts for his ability to maintain a strong core, better alignment of his body, and some of his ridiculous footwork.  Since it needs to be stated, I’m a bit of an Antonio Brown fan boy as a Steeler fan, but his Pilates and TRX work outs look pretty hard too!

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