Friday, August 24, 2007

Low Back Pain in the Athlete

Low Back Pain in the Athlete

Ok, so lately I have had an influx of athletes who are in excellent sport specific shape but have mild to moderate back pain with sporting activity. So the question is “Why do these exceptional athletes, who are in fantastic shape, have back pain?” Well, at least in my practice there are the following consistencies.
1) Overtraining: One of my first questions to athletes with back pain is “Do you have an organized training schedule and how often do you take rest days?” The usual answer is “I don’t have an organized training schedule (aka periodization training schedule PTS) I just go out and train as often as possible.” Most, if not all athletes that do not have a strength coach overseeing every part of their PTS usually train improperly due to overtraining or lack of rest frequency. What ends up happening is that the athlete starts to overuse or stress tissue to the point that it cannot heal properly and soon after the tissue (usually muscle tendon tissue) is damaged. Muscles of the low back are highly susceptible to stress injuries. So when stress injuries to the back are present the best treatment is rest and physical therapy to promote proper healing.
2) Compensation: Sport specific training is all the rage these days such as movement pattern training, core training, functional training etc, and these techniques are great, but many times the athlete is compensating around problems that are not always evident when observing this type of training. I find that many athletes have imbalances and compensate for weaker muscles while doing this type of training. It is imperative that one do manual muscle testing of all muscle of the lower extremities, pelvis and trunk to determine if one or more muscles are weak. Many times I find different prime movers compensating for weaker accessory muscles. This places an increased strain on the muscles themselves and the joints above and below the muscles in questions. So make sure to do your checks and balances of all muscles even if the athlete exhibits exceptional prowess.
3) Flexibility: Wow, I cannot believe how many athletes I come across with poor flexibility. Flexibility is key to healthy muscles and joints. Longer muscles promote proper energy transfer through the body and therefore cause decreased stress to the anatomy and therefore decrease stress to the back.
4) Poor Training Technique: This happens all too often. The athlete, without a strength coach or skills coach, will go and do lifts or sports specific techniques with poor technique. This will more than likely overload the surrounding back anatomy, therefore causing failure of the anatomy to resist injury. The best thing to do prevent this is to properly educate the athlete and make sure that they understand what they should and shouldn’t do when training. Make sure they have a developed and proper PTS that individually meets their needs and that dictates what safe lifts are and techniques they should do on their own.

Though there are many reasons, avenues and pathologies which cause back pain in athletes, in general the above reasons are consistent with our mild to moderate cases. I hope this was helpful. I look forward toward your comments.
-Mike

For further information on Athletic Training or Physical Therapy please contact COR Clinic through www.corclinic.com or 480.272.74638. Thank you.

The Last of a Shoe

The Last of a Shoe

The “foot print” or shape of the base of a shoe is known as the Shoe Last. Performance shoes (New Balance, Asics, etc.) today have different lasts to fit different shape feet.
To figure out if your foot is right for a performance shoe, all you have to do is take out the insole of the shoe and place your foot on top of the insole. If your foot does not follow the insole, the shoe will not properly fit your foot. If your foot covers the insole with about 1/8 of an inch of insole showing around the forefoot and toes of your foot, that performance shoe should be just right for your foot.

Please consult a local shoe professional or COR Clinic to determine proper shoe fit. www.CorClinic.com 480.272.7638

Friday, August 3, 2007

What to look for in a running shoe?

What to look for in a running shoe?

Significant advancements in running shoes started in the 1970's when Nike developed and brought about the inverted waffle outer sole and Nike Air sole. Since then, running shoes from many brand names such as Nike, Adidas, New Balance, Asics, Brooks, and others have advanced the technology of running shoes to what they are today, a highly dynamic, supportive, functional piece of sporting equipment that can prevent injury and improve performance.

Here is information to find a good pair of shoes for you:

The Pronated or Flat Foot Type
The first thing to look for is a shoe with a structurally stiffer sole. You can test shoes stiffness by placing a shoe in the palms of both your hands and then twisting the shoe like you are ringing a towel. If the shoe does not easily twist this shoe can provide increased support. While the shoe is still in the palms of your hands check to see where the shoe flexes. You can do this by taking the toe of the shoe and heel of the shoe flexing them toward each other. For the flat foot type, a proper shoe should break in the front 1/3 of the shoe and no other place. This will allow increased mid and rear foot support and improve foot control. Now that the sole of shoe has been checked for rigidity, one should check the stiffness of the heel. To do this take your thumb and index finger and go on either side of the heel of the shoe and try to pinch it together. The heel of the shoe should feel very stiff and lack movement, this will allow the heel of the foot to stay under control, which is usually lacking in a flat foot type.

The Supinated or High Arch Foot Type
This foot type needs a shoe that is very compliant or flexible. So unlike the flat foot, the high arch foot needs a shoe with a lot of cushion. The twisting of the shoe should be moderately flexible, but not so flexible it twists over on itself. The shoe should not have motion control in the shoe. You can usually tell if it has motion control by the different color rubber (usually dark gray) on the inside sole vs the outside.

Note of interest about foot types:
It is not easy to self diagnose your foot type. This should be done by a licensed physical therapist or podiatrist. This will allow you to properly understand your foot and which shoe is appropriate for you.

Please contact the professionals at COR Clinic to determine what foot type you have.
COR Clinic 480.272.7638
www.CorClinic.com