Ease Nagging Shin Splints While Continuing To Run

Shin Splints seem to be one of the biggest nagging complaints I hear from a variety of runners.

While many times some simple warm up and strengthening exercises can help. Often times the discomfort continues to linger, and as mileage accumulates things can start to become more and more of an issue.

On Track Physio provides alternative solutions to address this very injury. We have seen this issue many times before and won't waste your time with exercises or stretches that you are already doing. 

As a collegiate track athlete myself, I know exactly what you are dealing with. I can talk with you about strengthening, stretching, and running form. But I also recognize that sometimes certain muscles tend to respond well to some TLC treatment. 

We offer cupping and dry needling as a treatment of choice, which tends to work well if you already have the basics down.

The pictures below show the recovery modalities we use which on contrary to popular belief are actually quite comfortable (or at least should be! You do not need to aggressively dig into these already aggravated tissues to get reults). 

Contact us today to see how we can help you continue doing what you love!

B39myBoCQAA_eOo.jpg
Photo-Jan-31-4-23-23-AM.jpg

Ann Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

3 Ways To Stay Running Even If You Have Achilles Pain

When starting a running program, or if you have been running for quite some time. Chances are you may have encountered some achilles tendon pain. 

Chances are if you went to your physician or some other healthcare provider they may have told you to rest, ice, stretch, and perform some generic exercises. If this is all that you are doing, then it's no wonder why you still have not noticed any improvement.

I tell you why you should not stretch here.

I show you what to do instead here.

Finally, there are some other considerations you should make.

#1 ) Shoes 

Shoes do matter! Often times I will see people who just started running in zero drop heel shoes get pain because there tendon was never acclimated to this much range of motion under dynamic loading conditions such as running. Another thing I notice is that people become very patterned in their shoe. Either they put a lot of use on the inside of the shoe or outside of shoe. You want a shoe that allows you to feel the whole foot evenly. 

#2) Increase stride frequency and decrease stride distance while running. Think swift and quick with your legs. Often times people will report more comfort while running or jogging when they shorten their stride up and quicken their stride frequency. The result of this will be decreased impact on ground contact time, which results in decreased impact on the Achilles.

This modification often helps allow you to continue jogging or running if that is your goal. It does take some practice and coordination though, which is something we can definitely help you learn in addition to the specific exercises and treatment that will resolve the pain. 

#3) Land on whole foot, watch amount of heel drop when running. Usually sprinters have the most trouble with modification to achilles pain because sprinting requires them to be on the balls of their feet. 

A distance runner has more options on how they contact the ground when running. Landing on the whole foot while jogging or running tends to be the most comfortable. By decreasing the space and contacting the ground with the whole foot or rearfoot then we decrease the amount of dynamic stretch that is placed on the achilles.

The dynamic and quick stretch is often the pain generator. 

If you are a sprinter, the modification is making as rigid of a foot as possible so the heel does not drop into a quick stretch of the achilles. This modification allows you to stay on the balls of your feet, but decreases the distance the heel will drop when contacting the ground. 

In some instances we can not get around the pain and need to shut things down for a little bit until pain is more manageable. However, often their is a compromise that we can find.

If you'd like to see how we can help you recover FASTER. Fill out the short form below:

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Why you should STOP stretching your Achilles Pain!

I see people with achilles pain stretching their achilles constantly. 

The problem with this is that tightness is just a sensation. Often people feel tight in the calf because of the position they stand in all day long.

Likewise if you have pain, the body is going to protect you from going through any extreme range of motion for safety reasons. So it provides a sensation that encourages you to stop. 

Below is a picture of a common posture or position that many people stand in often.

forward-plum-line-with-line.jpg

As you can see, the hips are forward as compared to the lateral portion of the ankle joint. So if your hips and your ribs flare forward you are essentially leaning forward on the balls of your feet. In order to prevent yourself from falling forward, you calf muscles have to contract in a lengthened position to hold you upright. 

So in other words you calf muscles are always on. So just by position, this individuals calf muscles are already on stretch.

The other reason you should avoid stretching an achilles injury (especially the closer it gets to the insertion on the heel) is because a tendon injury implies the the tissue/tendon is compromised. We all know that muscles are elastic. So I like to use the analogy of a rubber band. If you stretch a rubber band too much it becomes weaker. Furthermore, if the structure of the rubber band is compromised, it doesn't hold up to well to aggressive stretching. So why would you treat your muscles this way?

Screen-Shot-2016-12-10-at-8.01.59-PM-300x293.png

This image I think explains a lot about how the structure of your heel (calcaneus) impacts the achilles tendon. And why if you have consistently been stretching your tendon it can cause friction against the bone....

More than likely you need to introduce a strengthening program. This is done through an appropriate range of motion depending on your presentation. Addressing some positional faults as well, which we eluded to earlier would just be icing on the cake.

To learn more about how we can help you with this process, apply for a free discovery session.

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Alfredson Protocol for Achilles Tendinopathy

If you have ever experienced an achilles injury or dealt with chronic achilles re-injuries or tendinopathy chances are your physician may have recommended something called the Alfredson Protocol.

This is an aggressive loading program with the intent of building back the strength and capacity back up in the tendon so that it can withstand normal daily movement as well as the activity levels your more than likely looking to regain. 

The Alfredson Protocol consists of 2 exercises performed for 3 sets of 15 reps that would be repeated 2x per day (which is a total of 180 reps every day). 

This is one of the exercises below. There are ways to make this activity easier or more challenging depending on the clients symptoms, strength, and skill level.

Now I know what you are thinking....thats a lot of reps, and that is probably going to hurt!

The reality is that this is a protocol which is standardized for research purposes. Many people do not do well with this aggressive approach. This approach is modified or altered depending on location of achilles pain as well. The exercises for mid achilles tendon pain are different than insertion (or at base of heel).

Having seen numerous achilles tendon cases before, we at On Track Physio have found that while this strengthening approach certainly works, we also need a menu of exercises to choose from which allows the client to perform the activity comfortably. 

Depending on your case and presentation we may also recommend less repetition or utilizing a heavier weight. This very much depends on the person.

Likewise, to make things even more comfortable, we have found that utilizing soft tissue techniques in conjunction with this will allow you to perform the exercise more comfortably. Below is a picture of cupping, which applies a distraction force to the tissue. This sensation seems to work better than compressive massage techniques possibly because achilles tendinopathy tend to be a repetitive compression based injury. In some instances we will perform dry needling, but not always.

20180423_121427.jpg

The more comfortable you are able to perform the exercises, the more likely we can continue to progress the exercises and perform them on a daily basis. On a daily basis is a very important part of this process, which is why once we determine the correct exercise for you, it's just a matter of doing it. We do not need to see you very often, we just need YOU to do the exercise daily and remove or modify the aggravating factors (something we will also help you do). Our goal is never to stop you from being active, however we may need to modify things slightly so that it gives the tendon a chance to recover.

To learn more about how we can help you with this process, apply for a free discovery session.

Ann Arbor, Mi

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

How To Stay Active and Recover from Achilles Tendinitis

Achilles tendinitis is a common complaint in the active population. It starts becoming more common with people in their early 30s or 40's, but can certainly impact people of all ages.

It tends to develop for a variety of factors. Usually the onset is associated with some type of quick spike in activity levels. Something such as increasing mileage of a run, or summer starting and you jog outside on different terrain, etc. It could have also been the addition of playing another sport or including more dynamic movements in an exercise program.

Either way, looking at the activity levels over the last month usually (not always) gives you a better idea of what may have predisposed the area to aggravation if it wasn't first gradually exposed to the task over time.

Once you are in pain or dealing with an achilles issue the game starts to change. As usually just resting and icing does not seem to alleviate the problem. If it would, you would notice relief in 3 weeks or less.

The other problem is that maybe you did get quick relief from resting, but you continue to re-injure or aggravate the issue when you try to resume your normal activities.

Aside from activity modifications that do not place as much dynamic demand on the achilles, the second order of business is to start building strength and capacity back up into the tendon.

After an achilles injury or strain happens, the tendon itself is weaker and does not have the loading tolerance it used to have.

We address this through the Alfredson protocol. The alfredson protocol is a well researched exercise protocol that helps with achilles tendon injuries. The one caveat is that this is a pretty aggressive and demanding exercise program and is not appropriate for everyone. Being too aggressive with this protocol can cause a lot of extra unnecessary soreness. 

We have treated a number of these cases over the years and found ways to make the exercise easier or harder based upon the clients skill and injury level. Furthermore, we have found great success with modifying the load and reps to what is correct for the particular individual. 

On top of this, we perform various soft tissue treatments in conjunction with the exercise program. The purpose of this would be to allow for more comfortable performance of the exercises. We tend to favor cupping for this but other methods may certainly be used as well. 

In total, most clients do not see us more than 1x per week for this issue. In some more extreme cases we go 2x per week until the pain is more under control.

To learn more about how we can help you recover FASTER from this issue, sign up for a free discovery session below.

Bonus content: Why you should avoid stretching Achilles Tendon Injuries

 

Ann Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Shoulder and Tricep Pain

Nagging shoulder pain can be a real pain to put up with throughout the day!

It impacts just about everything you want to be doing from reaching overhead, putting your seatbelt and jacket on to just name a few. It also can prevent you from performing you normal workout and fitness exercises as well.

In this case study from On Track Physio we are going to look at shoulder pain as well as tricep pain that caused a grabbing or catching pain in shoulder, as well as pain in elbow upon full extension of arm.

When we examined the shoulder he had pain with overhead motion as well as reaching across the body. Resistance testing indicated a few particular muscles in the shoulder that we wanted to address via soft tissue work as seen in video below.

We then followed this up with specific exercises that he was able to perform at home as opposed to visiting the clinic multiple times per week. Within less than 6 visits he has back to his normal fitness program with minimal to no limitations in the shoulder and confident to continue on without treatment.

At On Track Physio we don't waste time performing meaningless "filler" activities. We pick the most efficient treatment based upon our assessment to get you back to your goals the FASTEST.

If you are interested in Dry Needling we offer a discounted trial session $37 to see if you like it. 

To try your first session of Dry Needling, click here!

Ann Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Cervicogenic Headaches (Part 4)

The final type of headache which we will be discussing is called Cervicogenic Headache.

(You can read about Tension Headaches or Migraine Headaches)

Cervicogenic headaches are generally caused by pain involved with the neck itself.

As mentioned in the previous articles, muscular tension in these areas can be a big contributor. The only way to know which muscle is involved is to assess neck motion in a variety of different positions. Often times you will find one particular direction that is limited, which then would correlate with addressing a particular muscle group. 

 This by far and away is the most common test that I find is limited.

This by far and away is the most common test that I find is limited.

So it's not only important addressing the neck motion limitation, but give you ways of self treating at home so that you give yourself the best possible chance of not having the issue resurface.

At On Track Physio, we not only focus on treatment that will help your symptoms. But also look big picture at what you can best be doing to address the cause of the issue as opposed to always being reactive and just addressing the result. This is how we can give you much better long term solutions.  

If you'd like to start being in control of your headaches, we provide a FREE Discover visit. This free appointment is all about getting clarity back into your life and providing you with potential solutions.

Apply for a Free Headache Discovery Session | Ann Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Treating Migraine Headaches (Part 3)

In part 3 of our headache series we are going to be covering Migraine Headaches.

(You can read about Tension Headaches or Cervicogenic Headaches)

Migraine Headaches are often described as either WITH or WITHOUT aura.

An "aura" is a distinct sensation that is all to commonly felt just prior to a severe headache or migraine about to start.

As opposed to tension type headaches, migraine type headaches tend to be more one sided in nature. People will often describe blurring of vision, sensitivity to light, nausea, numbness, possibly even vomiting.

As mentioned with tension type headaches, neck position and muscle tension can play a large role into symptoms. Often times with migraines and cervicogenic headaches you will find neck motion limited to one side more so than another.

suboccipital triange.png

The above picture shows muscles in the neck that are commonly referred to as the "suboccipital triangle". They tend to play a major role into limiting neck motion as well as irritation correlating with migraine and headache symptoms. 

Often times addressing these muscles properly can lead to effective treatment results. In combination with specific exercises based on range of motion limitations in the neck which you can perform at home is the best and most natural symptom resolution treatment options. 

If this sounds all too familiar for you, we provide a FREE Discover visit. This free appointment is all about getting clarity back into your life and providing you with potential solutions.

Apply for a Free Headache Discovery Session | Ann Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Tension Headaches (Headaches Part 2)

Today we are back in Part 2 of our Headache Series.

Tension type headaches is the most common presentation of headaches. 

(You can read about Migraine headaches or Cervicogenic Headaches)

Generally these type of headaches cause pain in the temple region which can also refer pain behind the eyes. 

These symptoms tend to be bilateral (meaning on both sides of the head). The pain is often described as a pressure or tightening pain (non-pulsating). The intensity is mild-moderate, and frequency of occurrence is quite high (> 15 per month).

UT Headache.jpg

The picture above shows the area which people with tension type headaches feel it the most. Sometimes it can be referred to a "rams horn headache" because of the path the symptoms follow. 

As the name implies "tension" these symptoms are usually provoked from excessive muscle tension. The most common muscles involved are the upper trap, sternocleidomastoid, and suboccipital muscles.  

head-weight.jpg

You have probably guessed it, the position of your neck which you assume frequently plays a big role in headaches. It's not that looking downward is bad or that your head should always be upright in a military type posture. It's that quite often we assume this position too often without changing position. 

It's no different than sitting on a hardwood chair for a long period of time, at some point you have to shift pressure and off load the buttcheek. 

The problem becomes difficult when it is uncomfortable or difficult to change neck positions. More than likely this has been something accumulating over the years and over time developed into a bigger and bigger problem.

How we address tension type headaches is first understanding what may be provoking them. This could be a certain activity, your daily neck position, overactive and tight feeling muscles, or a limited neck range of motion.

More than likely it will be a combination of these things. At On Track Physio, we have unique ways of addressing all of these limitations. So if all you have tried is some generic stretches/exercises, massage, and medication we have other effective options available for you!

If you are tired of dealing with frequent, annoying, tension type headaches we provide a FREE Discover visit. This free appointment is all about getting clarity back into your life.

Apply for a Free Headache Discovery Session | Ann Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Treating Headaches Without Use of Daily Pain Killers (Part 1)

Chances are that either you or someone that you know has been dealing with frequent/daily headaches or migraines. In fact, some research shows that migraines are in the 10 highest causes of disability worldwide (Steiner et al, Cephalalgia, 2003).

Headaches.jpg

So if you are currently experiencing this, please realize that you are not alone.

Unfortunately for most people, they resort to medication for relief. Medication certainly helps some cope with these episodes. But for many others, the medication provides minimal to no relief for the issue. In both cases though it certainly is not a long term solution as chronic reliance on medication has many other negative health consequences.

Perhaps the bigger issue with medication is that it does not provide any resemblance of control over the issue. We all know that when a severe migraine or headache hits, it stops you dead in your tracks and doesn't allow you to function normally throughout your day.

You may have to use your vacation days at work, call off your fun plans for the weekend, stay at home inside and not enjoy the weather because the brightness is too much for you.

At On Track Physio we know you don't want to be canceling fun plans last minute due to a sudden severe headache. Which is why we offer solutions to get at and find the root cause of the issue. By addressing it accordingly we can often give relief, decrease frequency of occurrence as well as intensity, and most importantly give you control back over the issue so that it doesn't prevent you from doing what you enjoy.

When considering treatment, the big thing we need to understand is that there are a variety of different headaches. Which is why you need a clinician who understands the differences in order to give you the best shot at finding relief. Generic treatments will give you generic results!

The most common types of headaches I see are the following:

1) Tension Headaches

2) Migraine Headaches

3) Cervicogenic Headaches

If you find this resource helpful, please share it with a friend. As always we would love to hear from you and discuss how we may be of benefit to your problem.

Apply for a Free Headache Discovery SessionAnn Arbor, Mi

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

What Pain, Legos, and your Mom have in Common

Simple analogy for one of the most often questions I'm asked on a daily basis. "Why did (insert body part) get hurt when I didn't really do anything to cause it?

Watch to video below to learn more.

It's about recognizing what needs work, and picking 1-2 things that are most efficient at addressing it to help prevent "stepping on the lego". If pain is present, then finding 2-4 things to do which are most efficient and do them often until the mess is cleaned up.

My job is to find what it is that will be most efficient to helping you clean up the mess and keep in cleaned up for the future.

Ann Arbor, Mi

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

What High Quality Physio Should Look Like

If you are going to trust a healthcare provider with your recovery, it's important to know what distinguishes high quality from poor quality. After reading this post you should know the difference so you can ask the right questions before getting started. That way you never have to experience poor care!

What Poor Quality of Care Looks Like:

This is my rant for the month.  A good amount of the clients we see, come to us after having failed elsewhere or by another healthcare provider. Some have felt pretty much ready to give up and ‘just live with it, until they were talked into giving us a try by previous clients of ours.

In most cases these folks tell me that they were actually only seen briefly by their healthcare provider.  Maybe some quick hands on treatment, then out the door. Very little or no education/guidance was given on their injury or issue. Those who do have longer treatments tend to be passed off to a lesser qualified personnel or just left to do their exercises on their own most of the time (since the therapist/clinician was busy with other patients).

Needless to say the results were not what these folks were hoping they would be!

      image credit: www.glasbergen.com

     image credit: www.glasbergen.com

Generalized treatment leads to generalized results.

Delegated care leads to less educated professionals providing less skilled treatments.

Ultimately landing you with a watered down treatment approach that results in poorer outcomes and breakdown in communication...... Not to mention that these business usually try to make up for lesser quality of care by having you come in more frequently than necessary in hopes that their outcomes will improve at the expense of your precious time!

At On Track Physio, we guarantee this will not be your experience. We even back it with a money back "Love it or Leave it" guarantee! Something you never see  in healthcare..... If you’re going to spend your hard earned money on our services then it should be focused on YOU and the outcome you are trying to achieve!

Here is what High Quality of Care should feel like:

1) Time is actually taken to listen to and understand YOU, and your story about the path which lead you to your current state or current issue. 

2) Time is actually taken to allow you to ask questions

3) Time is taken to perform multiple assessments each and every visit to best ensure that the intervention given will be most likely to produce the outcome which is desired.

4) Time is taken to demonstrate, teach, and coach the exercise or intervention so it is done properly. But is also repeatable for you to do at home independently of a healthcare provider. This gives you the best possible chance of achieving the desired outcome.

5) Consistent communication throughout the entire plan of care to avoid setbacks.

6) Truly skilled clinical experience and knowledge/understanding of how the entire body works as a unit. Focusing on just the painful area will get results some of the time, but the majority of the time there is multiple contributing factors.

Note: Notice how items 1-4 emphasized time. If your provider is constantly juggling clients or passing you off between provider. Your TIME would be best spent elsewhere!

Obviously we are biased..... At On Track Physio we guarantee that we will show you all 6 of these traits to receive high quality care. If you would like to experience this quality of care, please feel free to reach out to us via phone, email, or schedule a time for a FREE Discovery session. This session is all about giving you the TIME needed to make a good choice in your health.

Greg S.jpg

Ann Arbor, Mi

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Snapping Hip

Recently I have had a string of clients present with a "snapping hip".

This isn't a medical diagnosis per say, but it is a symptom that many people deal with. The individual typically notices a random "popping", "clicking", or "snapping sound" from the front of their hip. It tends to feel different than cracking your knuckle, and it usually occurs when flexing the hip up. Or when they extend their hip back. 

Most people come to me and they say that they have tried a variety of different things before to help with it, but nothing seemed to make a difference. They have tried things such as stretching, strengthening, massage, dry needling, foam rolling, etc but no relief. 

No relief is noticed because using the above strategies did not address the problem.....So what is the problem?

I've treated many of these cases, and more times than not the individual will experience their symptoms in the following test:

The individual will notice a couple things...

1) The snapping either occurs as the thigh slowly lowers down...Or when the thigh is parallel to the ground and the individual flexes their hip back up toward the chest.

2) The individual will usually notice the thigh is able to get to a position that is parallel to the ground (so they have plenty of motion). But will have a tendency to want to move their leg out wider in this position or turn their foot outward because it feels more natural and comfortable.

So what's happening?

In my opinion this is a person who has put a lot of stress repetitively throughout the years to the front of their hip. As such, the individuals stabilization strategy is to compress at the front of the hip as opposed to utilizing their muscles properly to help keep the joint moving with proper congruence. 

images.jpg

The picture above explains what Im talking about. You can see the joint roll across the muscle/tendon and that, in my opinion is what you are feeling. Some would say that this muscle is "tight". However, I would respectfully disagree....

Notice in the left picture how the joint faces us more. This is not optimal joint position. This is the strategy that you've most likely adopted to stabilize. Compressing and putting pressure on the front of the hip.

Now the fix for this is training a specific muscle called the glute med through full range of motion at the hip in all planes.

download.jpg

Most people who have this feel a lot of quad and TFL activation with various exercises and even at rest. This is just more confirmation that you are front side biased in stabilizing the hip. They have a very hard time feeling the activation of a glute med muscle or musculature around that area when asked to perform certain hip strengthening activities.

Once the client learns how to feel this muscle, all of a sudden their symptoms tend to go away. Now this exercise is not just some simple squat or lunge. Trust me I wish it was....

Often times I spend 30 minutes to an hour just trying to teach someone how to feel this muscle work with a particular set of exercises.  But by the end of the session they notice a positive change in their symptoms and now they have homework to do.

If this sounds like you, or a friend, please share it with them. I'd love to set an appointment time up where we can talk about this in greater detail, and how On Track Physiotherapy can help. Just hit the discovery session button below to learn more.

Greg S.jpg

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Why Stretching Your Hip Flexor Isn't Alleviating Your Hip Pain

Have pain or discomfort in the front of your hip?

Does it hurt when you run, jump, sit, or squat?

Have you tried stretching the front of you hip out but only got about 2 seconds of relief from doing so?

Pain on the front side of the hip can be really annoying! It tends to start out at a low level discomfort that doesn't really impact you much...but it's just there! Then slowly and gradually you notice it impacting you more and more, eventually turning into an annoying toothache like symptoms in the front of your hip.

You've probably intuitively thought that this doesn't really feel like a muscle issue. It feels deeper than that. So you do what your high school gym teacher, trainer, coach, or even physical therapist told you to do.....stretch it out!

Only you notice about 2 seconds of relief.....Maybe 10 seconds if you hold the stretch for 10 seconds. But once you stop stretching the annoying toothache pain in the hip comes back.

Einstein said it best...."Insanity is doing the same thing over and over again, but expecting different results."

I see this all the time in the clinic, and have treated these cases successfully time after time. The first step is finding out if you shoulder STOP stretching the front of your hip. 

Watch this video to help you understand.

The first step in recovery is always to remove the provocative factors. Putting too much stress and pressure frequently throughout the day on the front side of the hip is quite frequently part of the problem. So we don't need to be feeding into it further by forcing the issue.

If you've been dealing with an issue similar to this, I'd like to invite you to schedule a free discovery session to dive more deeply into what SPECIFICALLY you need to be doing to get rid of the problem so that it doesn't turn into a bigger issue than what it's already become!

Real Solutions For Hip Pain| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Why Your Knee Hurts With Squats and Stairs

Pain in the front or side of your knee?

Clicking or popping around the kneecap?

Don't be so quick to blame the knee! We see this all the time at On Track Physiotherapy. Client comes in with knee pain and has difficulty with squatting, stairs, etc. 

Often times people think that this is a knee issue. When quite often it actually has more to do with the hips and foot than anything. 

When people think about the knee, many believe that it just bends and straightens. When in reality there is actually a decent amount of rotation that is normal and should occur at the knee with various different tasks. 

This is because you hips and ankles have more degrees of freedom than the knee. Move your ankle or hip around for a moment. Then move you knee. Notice how many more options are available to the ankle and hip.

This puts your knee "a.k.a the middle man" at the mercy of the hip and ankle. Your body is like a tetor toter, if one end moves, the opposite end is going to do something as a result. 

So if you hip or ankle do not have the motion necessary to accomplish the task, it causes the knee to work overtime.

If your hip and ankle don't have stability and control, then the knee takes the brunt of the stress.

Your body needs controlled motion available throughout the lower extremity to distribute forces and start feeling better.

Listen to the video above, as I explain this in more detail. 

Real Solutions For Knee Pain| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

The #1 Reason Your Back and Hip Pain Has Not Resolved

People deal with low back and hip issues on a weekly and monthly basis. Unfortunately in some cases, low back and hip discomfort can be a daily struggle. 

Seemingly simple tasks such as bending forward to put your socks and shoes on, or transitioning in and out of your car become more difficult. In some cases, it's annoyingly uncomfortable. 

A lot of people will try various different stretches, strengthening, and stability based exercises to help improve their symptoms. They may even had tried massages or various different manual therapy techniques. These are all great ideas, and work well in a lot of cases. However, there is another subset of people who do not respond to typical measures of exercise and rehab. It is also very possible that if your noticing progress, but it just seems to be slow. There could be other factors you have not yet considered which has slowed or plateaued your progress.

In the video below, I'm going to be discussing one of these reasons.

It's not often NOT talked about by your rehab clinicians or personal trainers. It certainly is never discussed in the 15 minutes you get to spend with your primary care physician or orthopedic consult. And yet, it's one of the most basic things that all humans must be able to every day. 

If your still looking for answers and reasons for why your back or hip pain may be lingering around longer than you'd like, we at On Track Physiotherapy can provide answers and give you the time necessary for an explanation.

The first step is setting up a discovery visit so you know what to expect. We can answer any questions ahead of time, and if you feel that we are a good fit then we can move forward with treatment. Let us know the outcome you'd like to achieve, and we can tell you how our services can better help get you to that point. 

Low Back Specialist Physiotherapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Low Back Compression Explanation

Do you frequently wake up in the morning with a "tight" back?

Does your body just feel stiff and doesn't want to loosen up?

In this video we explain why people start to experience stiffness or tightness in their back that just doesn't want to ease up. 

The good news, is there are effective strategies to put a halt to this once and for all! Set up FREE discovery visit with On Track Physiotherapy to learn how.

3 Reasons Why Your Still Feeling Low Back Pain, Stiffness, and Tightness

Chronic low back pain, stiffness, and tightness is one of the most common things I see and treat in the clinic on a daily basis. 

If you are currently experiencing low back pain, stiffness, or tightness that just doesn't seem to go away. You are not alone. In fact, millions of people deal with this issue unfortunately on a daily basis in the United States.

Many misconceptions about low back pain exist from individuals giving generalized recommendations. In today's article, I will discuss 3 common reasons why you're still experiencing pain, stiffness or tightness in the low back that not many people talk about.

If you have ever been to the Doctor and been given diagnosis such as: degenerative disc disease, spinal stenosis, etc. you'll want to be sure to read all the way through. Too many healthcare clinicians give out diagnosis but don't ever explain what's going on and why your experiencing the current issues in the first place. If your going to try to solve a problem, wouldn't it make sense to first understand what the problem is?......

Reason #1 ) Your body craves stability and control. If you are unable to provide it with enough control actively (using your muscles) then it will find a way to do it passively (bones, joints, ligaments, etc). Muscles have a much greater capacity to recover than passive structures, especially in the long term. 

Reason #2) Does it feel like you are constantly arching your back? Take a look at the picture above. See how the hips shift forward, the beltline points downward, and the ribs point upward. This is a position of extension and compression. Which in and of itself is not a bad thing. We just don't want to live there 24/7. 

Anyways, you will find people who frequently stand, sit, walk, etc. in this position. As you can see from the lines drawn, this puts a lot of compression on the low back structures and creates a lot of tightness in those low back muscles. Said another way, if you are in that position frequently, you are relying on passive structures to support your body frequently.

Reason #3) Let's look at this position a little more.... Below is a picture of a pelvis and low back model with the joints in "neutral". Neutral is a relative term, because when you move so does your joints. 

However if you are relying on passive support systems and compression to create control then your body defaults to that positional strategy. Which is the picture below. Notice how the hips flare further out to the side and the back hip bones start to approximate toward midline reducing space.

Hopefully these pictures provide some clarity for you. Holding a pelvis model in one hand and taking a picture in the other is not an easy task, but I think you get the point....

Frequent extension, compression, and passive support lead to feeling achy, sore, stiff, and tight. On Track Physiotherapy is your solution to finding an active way to provide relief and stop the daily annoying nuisance your back is currently experiencing. 

Not yet ready to come in for a visit, no worries. But please get started doing something....Click below to get your free report on Low Back and Hip Pain. 

Low Back Specialist Physiotherapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track Physiotherapy in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Injuries and Prevention - Part 3

Here is video #3 in our series on box jumps to decrease the risk of ACL injuries and also to improve jumping performance. 

If you have not watched the previous two videos, you can do so below:

Part 1

Part 2

Remember these exercises alone are generally not the complete solution. This is just one piece of the puzzle and their are other aspects of training that should be addressed as well if you are looking complete recovery or do all you can to prevent an injury.

If you want more information on the topic, be sure click the image below to get your free tips report!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Injuries and Prevention - Part 2

Last week I talked about some of the main causes of ACL injuries and why they occur at a rate of 3-4x more often in female athletes.  You can find that article along with our first jump training video HERE:

This week I’m posting the second video in a series of three showing how we begin jump training to a box.  This type of training can be used for ACL injury prevention and to enhance sports performance.  It’s also what we do post-surgically to get the athlete used to jumping again and landing safely.

The great thing about box jumps is that the forces on the knee are quite low because you are not coming all the way back down to the floor.  It’s also much easier because of this for the athlete to work on proper landing technique.

Before I get to the video though I thought I’d post a picture of what you don’t want your athletes knees to look like.

Looks fairly simple but let me assure you it can be quite challenging for many athletes – boys included.  Learning to jump and land correctly has been proven to help prevent ACL injuries and it must also be a huge focus of any post-surgical ACL rehabilitation program.

If you would like to learn more about how to recover from an ACL injury or just better prevent one from occurring, click on the free guide below!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.