5 Tips to Help Prevent Running Injuries

  1. Progressive load tolerance: the majority of running injuries occur from doing too much too soon! Whether a tendinopathy, plantar fasciitis, patellofemoral syndrome, IT band syndrome, stress fracture, muscle strain, you name it, your body needs to learn to accept load gradually over a period of time so you don’t exceed the tissue’s capacity to adapt. Gradual progressions are important whether you are learning to run, returning to run after some time off, after a rest period following a race, or coming off of another injury. This will likely look like some form of run-walk progression – for best results, speak to your healthcare practitioner! (And a word to the wise runner, ALWAYS consult a healthcare practitioner who is also a runner themselves).
  2. Cadence of 180 steps per minute: research has shown that running with a cadence of 180 steps per minute (range from 170-190), regardless of pace or speed, is beneficial in terms of injury prevention. A slightly faster cadence than perhaps you are used to will be helpful in reducing the amount of contact time with the ground while taking a step, which reduces the amount of force transmitted through your foot, knee, hip and into your body. Transitioning to a different cadence than usual should also be done gradually!
  3. Run lighter: Perhaps this one seems over-simplified, but by taking quieter steps, you are also reducing the amount of force transferred through your body. You want to hear as little sound as possible when your foot contacts the ground.
  4. Run a minimum of 4 days/week: your body needs to learn to adapt to the stimulus of running, and will only do so if running occurs with enough frequency. Running only a couple of times per week will not allow for the appropriate adaptations in your muscles, bones, tendons and other tissues, thus resulting in a greater likelihood of injury. This does NOT mean that every run has to be fast or long! How frequently you run is the important factor here. Including speed and longer runs will vary depending on your running goals.
  5. Appropriate footwear: make sure to consult your healthcare provider on this one, but research has shown that running in shoes with a lot of cushioning and arch support can actually reduce your body’s capacity to regulate how much force is being transferred from the ground to your foot, ankle, knee, hip, lower back, etc. Ensure you have the right pair of shoes specifically for you!

For more advice on running injury prevention, treatment and return to run, consult one of our healthcare providers at Ace Sports Clinic.

Check out our Ace Running Programs here.

Written by: Hilary Mallinger, Registered Physiotherapist

Massage Therapy at Ace Sports Clinic

Massage therapy is the perfect complement to Osteopathy, Chiropractic, Physiotherapy, Personal Training and Pilates. It is also a superb treatment on its own or as part of a regular maintenance program to promote optimal tissue health. Taking time away from your computer, phone and other life stressors and simply focusing on your breath, listening to your body’s subtle messages of vitality, joy and relaxation help restore your mind and body. The ancient Chinese, Egyptian, Indian, Greek and Roman civilizations all reference the use of massage techniques as playing an important role in the healing process. With good reason, as there are countless proven and perceived benefits of massage such as improved sleep, reduced muscle tension, improved joint mobility, improved posture, better lymphatic drainage, decreased stress hormones, reduced inflammation and pain along with improved immune function.

3 Wellness Enhancing Benefits of Massage Therapy

1. Improved athletic and fitness recovery

The ancient Greek athletes used massage pre-& post exercise, a theory still practiced today. A decrease in swelling and delayed onset muscle soreness (DOMS) by 30% was found in a 2005 study on The effects of massage on delayed onset muscle soreness, swelling and recovery of muscle function. “This suggests that a massage performed post exercise but before DOMS develops can alleviate soreness, no matter how the massage is performed”. Interestingly, the upper arm circumference was measured pre and post massage and the treated arm had a significantly smaller increase in circumference, demonstrating a prevention of swelling

2. Improved immune function

In a 2010 preliminary study by Rapaport et al, a 45-minute massage therapy vs light touch therapy group found “the data do support the notion that a single session of Swedish Massage therapy may have fairly profound acute effects on the immune system” compared to baseline results and a light touch control group. There was a decrease in cytokines, interleukins, cortisol and vasopressin, and an increase in the number of lymphocytes (white blood cells).

3. Shift towards a more Parasympathetic (Relaxation) state

Are you stressed?
Do you live in sympathetic overdrive?
Our autonomic nervous system consists of the sympathetic nervous system (“Fight or Flight”) and parasympathetic nervous system (“relax and digest”).
A 2009 study by Diego and Field, from The International Journal of Neuroscience reported the 1st half hour of moderate pressure massage calms the sympathetic nervous system and shifts to a more parasympathetic state vs the light pressure group which provoked a shift towards a sympathetic response.

So, consider a regular maintenance massage as less of a luxury, and more of a necessity for your physical and mental well-being.

Written by Ashly Metcalf, Registered Massage Therapist & Osteopathy candidate

1. Zainuddin Z, Newton M, Sacco P, Nosaka K. Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function. Journal of Athletic Training. 2005;40(3):174-180.
2. Rapaport MH, Schettler P, Bresee C. A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic–Pituitary–Adrenal and Immune Function in Normal Individuals. Journal of Alternative and Complementary Medicine. 2010;16(10):1079-1088.
3. Miguel A. Diego & Tiffany Field (2009) Moderate Pressure Massage Elicits a Parasympathetic Nervous System Response, International Journal of Neuroscience, 119:5, 630-638

Had a Concussion? Ace Sports Clinic can help with ImPACT

ImPACT: Immediate Post-Concussion Assessment and Cognitive Testing

What is ImPACT?

ImPACT, or Immediate Post-Concussion Assessment and Cognitive Testing, is a computerized test used in Toronto Physiotherapy at Ace Sports Clinic. It is an objective measurement tool used in the assessment and management of concussion and post-concussion syndrome (PCS). It is a scientifically validated and FDA-approved test that allows clinicians to track progress of neurocognitive symptoms throughout the management of head injuries. ImPACT should be accompanied by a full clinical evaluation of PCS symptoms.

What does ImPACT assess?

ImPACT involves a variety of computer-based tests that assess domains such as visual and verbal memory, reaction time, and visual motor speed, all of which can be affected with PCS.

What does ImPACT involve?

ImPACT can be completed as a Baseline test (pre-injury) or as a Post-Injury test. Baseline testing is done to determine values for the domains listed above prior to head injury and is highly recommended for athletes that play contact sport. Post-Injury test scores can be compared with the athlete or client’s own Baseline scores, and/or within population normative values (if Baseline data hasn’t been assessed). The computer test takes approximately 30-45 minutes to complete; however, may take longer depending on symptom severity with head injury.

What occurs after ImPACT?

Your clinician will use the values from the ImPACT test to help guide treatment, and can compare values as a means of objectively measuring improvement by completing a second or third test throughout the course of recovery.

For more information, please visit https://impacttest.com/.

Written by: Hilary Mallinger, Registered Physiotherapist and Concussion management provider

Sources: Shift Concussion Management, Inc.
ImPACT Applications, Inc.
Picture Source: www.britannica.com

 

All sweat is not equal: Know what you’re getting for your sweating!

Pilates exercises have become very popular among fitness enthusiasts, athletes, trainers and physiotherapists.  Pilates has the ability to train “the core” to “strengthen and lengthen” your muscles, and improve posture.  It is also an intelligent tool used to re-educate faulty movement patterns, including inefficient breathing mechanics, and to activate and tone your pelvic floor muscles (especially after childbirth).  It improves balance in muscle synergy and spatial dynamic balance.

by Alicia Malcolm Anderson – Pilates Instructor at Ace Sports Clinic

You can do any form of Pilates and find benefit, but if you’re looking to rehab an injury, manage low back or neck pain, seek pre – or postnatal care or to really take your performance to the next level, at Ace Sports Clinic we offer Clinical Pilates as part of a team approach, which is based on world class research and implementation.  Our team are very familiar with the original journal articles and the “science” behind Pilates.

Our goal is to be effective and leave you feeling educated and moving better than when we found you, not just sweatier and less stressed.

Ace Sports Clinical Pilates is a form of resistance exercise which includes a repertoire of hundreds of choreographed exercises designed to challenge your neuro-muscular system, strengthen throughout range and to train your co-ordination.  By the nature of how it is taught it also offers an opportunity for intricate understanding of your anatomy, function and movement patterns; by bringing awareness through palpation and teaching segmental movement and muscle activation.  This understanding of your body is generally not part of large, impersonal Pilates classes at your local gym.

At Ace Sports Clinic, we believe you can only improve to the degree you know your limitations.  This takes an expert assessment which is part of our Ace Clinical Pilates approach.

We treat what we test.  We observe how you move and where you generate movement.  We educate and work together to eliminate insufficiencies and excessive movement to help you become more efficient and reduce harm.  We provide an exceptional standard of care and achieve rapid results.

Not all Pilates is TAUGHT to equal EFFECT.  Generic exercise produces generic results.  Specific training using a specific tool in a specific direction yields targeted results.  This is the personalized approach we use at Ace Sports Clinic, which impacts not only on your quality of movement but response to pain, ability to function and perform at your highest level.

Performing exercises that are customized to your movement pattern incoordination, muscle timing delays or strength imbalances, may result in immediate increases in performance, whereas performing exercises biased in the incorrect direction may result in decreased performance.

We want to be specific and accurate, because the power of what we do is in the subtlety.  Precise and mindful movement has the capacity to create radical transformation in the body.  It’s no coincidence the ‘best, most efficient movers’ in any sport generally have the least injuries…think Roger Federer in Tennis.

For profound results, from Rehabilitation to Peak physical performance – Clinical Pilates tailored to your specific needs, trust Ace Sports Clinical Pilates.  Let our professional exercise experts get you on the right track with an Assessment and personalized Pilates program today.

Call 416 792 4223 or visit www.acesportsclinic.com

6 Things You Have to Know about Concussion

Concussion. That word has become a hot topic as of late. Most of you have an idea of what a concussion might be. However, there are tons of misconceptions and poor information when it comes to concussion.

More importantly, there is a lot of confusion over what to do when you sustain a concussion.

So let’s try to clear up some of this information…

What is a Concussion?

An injury to the brain that affects the way the brain FUNCTIONS which is NOT the result of structural damage to the brain.  This means that the brain is not functioning normally, but nothing has been damaged within the brain tissue.

Therefore, if you performed imaging of a concussed person’s head (CT scan, MRI etc) nothing would appear.  If it did, this would be more indicative of a more serious brain bleed or stroke.  This is one of the reasons we have such difficulty objectively measuring whether someone has sustained a concussion rather than just relying on subjective symptoms.

How do you sustain a concussion?

There are many ways to sustain a concussion but the important thing to note is that direct impact to the head is not required in order to get a concussion.

Concussion can result from indirect (blow occurs elsewhere on the body and impulsive forces result in injury to the brain) or direct (blow to head, face or neck) forces.

So what is happening within the brain?

Truthfully, we still have a lot to learn.  What we believe is happening is a neuro-metabolic cascade.  In our brain (as well as everywhere else in our body) we have sodium/potassium pumps that open up to bring the metabolites in or out.  When we get a concussion, all the pumps get stretched so they all open at the same time and the axon gets clogged with sodium.  Now we have a lot more sodium then normal that we need to get out.  The only way we can get it out is by using energy (ATP).  The problem is, we get our energy from blood flow and there is actually decreased blood flow to the brain from the concussion. Therefore we have a mismatch – we need more energy and we are getting less.

How do we diagnose a concussion?

Diagnosis can only be made clinically.  It should be made by a trained professional, ideally at the sideline or later within the clinic/hospital.

There is no proven blood test or imaging that can be done to diagnose it.

There must be one or more of the following clinical domains:

  1. Symptoms that fall within 3 categories:
    A) Somatic (i.e. headache)
    B) Cognitive (i.e. feeling like in a fog)
    C) Emotional (i.e. lability)
  2. Physical signs (i.e. Loss of consciousness, amnesia)
  3. Behavioural Changes (i.e. irritability)
  4. Cognitive impairment (i.e. slowed reaction times)
  5. Sleep disturbance (i.e. insomnia)

If experiencing symptoms and/or signs in one of the above areas in combination with an appropriate mechanism to induce a concussion you likely have a concussion.

A trained professional will use outcome measures such as SCAT5 or Child SCAT5 in order to more objectively diagnose concussion. cThis can also be a tool used to monitor progress.

What to do once you suspect a concussion?

  1. The number one rule: NO SAME DAY RETURN TO PLAY. If you are in doubt if they have a concussion, sit them out.
    • If you sustain a second concussion before the first has fully healed you are at risk of developing second impact syndrome. A rare, but fatal, consequence of returning to play too soon.
  2. Monitor the concussed person every 15 min for 4 hours, then regularly for 24-48 hours.
  3. Bring the patient to the ER if any of the following is present:
    • Headache that worsens (one that keeps worsening and worsening)
    • Drowsiness or inability to be woken up
    • Inability to recognize people or places
    • Repeated vomiting
    • Worsening confusion/ irritability
    • Seizures
    • Hemiparesis/hemi-sensory loss
    • Unsteadiness
    • Slurred speech
  4. No alcohol or recreational drugs for 24-48 hours
  5. No aspirin, anti-inflammatories or pain killers for 24-48 hours. This can mask worsening headache or other symptoms.
  6. Do not drive until medically cleared

Recovery

While concussion diagnosis needs to be taken seriously the important thing to remember is that 80-90% of concussions resolve in 7-10 days.

If diagnosed with concussion, the earliest a person can return to sport is 7 days post injury. They should see a trained professional to run through a return to play protocol, and will need medical clearance before returning to sport.

If your concussion symptoms are persistent, our treatment can help.  Our physiotherapist will run through a thorough assessment to determine the main cause of your persistent symptoms and come up with an individualised treatment plan to get you back to sport, work or school sooner.

Suffering from elbow pain when serving or throwing?

Pain on the medial side (inside) of the elbow often plagues the overhead athlete.

If this pain persists it is usually an indication of either:

1. Medial epicondylitis (golfer’s elbow)

2. Ulnar collateral ligament (UCL) sprain

3. A combination of both of the above

What’s medial epicondylitis?

Medial epicondylitis, commonly referred to as “golfer’s elbow”, involves injury and irritation to a complex of tendons that converge to become the common wrist flexor tendon. This common wrist flexor tendon is mainly responsible for flexing the wrist and fingers, and attaches onto a bone at the inside of the elbow called the medial epicondyle. With injury, movements that generate force through the common wrist flexor tendon produce pain at the medial epicondyle. Most commonly, these movements involve stretching the common flexor tendon by extending the wrist/fingers or contracting the tendon by actively flexing the wrist/fingers. For tennis players, this will likely mean pain with serving and forehands as both these strokes involve aggressive wrist flexion and extension actions.

Just a quick note – the suffix “itis” in “epicondylitis” refers to inflammation and assumes that there is an inflammatory process associated with tendon injury as opposed to a degenerative process. Controversy in the research on this topic has spawned the term “epicondylosis”. So if you’ve ever come across both “epicondylitis” and “epicondylosis” with confusion it’s totally understandable. For the purposes of this post and for simplicity’s sake, we will stick with using “epicondylitis”.

What’s an ulnar collateral ligament (UCL) sprain?

The ulnar collateral ligament (or UCL for short) is a ligament that is responsible for providing support to the inside of the elbow. Similar to the common wrist flexor tendon, the UCL attaches to the medial epicondyle of the elbow and will thus produce pain here when injured. As with any sprain, a UCL sprain will cause pain when force is applied through the ligament. A force termed “valgus stress” puts the most stress on the UCL and will typically produce pain at the medial epicondyle when the UCL is sprained. A great example of valgus stress can be seen in the late cocking/acceleration phases of a baseball pitch or tennis serve (seen in the image below). It is during these actions that pain from a UCL sprain will be most pronounced in the overhead athlete.

How do you tell the difference between medial epicondylitis and a UCL sprain?

Although the location of pain in both conditions will be similar, a UCL sprain will typically be unaffected by wrist and finger movements as it has no direct attachment points there. Instead, a UCL sprain will be affected when valgus stress is applied through the elbow, manifesting in pain, and decreased accuracy and speed during a baseball pitch or tennis serve. Conversely, medial epicondylitis will be most affected by wrist and finger movements but not valgus stress through the elbow. It is also possible that a UCL sprain and medial epicondylitis can simultaneously co-exist. In this case, wrist movements, finger movements, and elbow valgus will all produce symptoms at the medial epicondyle.

Treatment

At Ace Sports Clinic, treatment of both medial epicondylitis and UCL sprain will typically involve soft tissue work and specific rehabilitation drills in order to guide tissue healing and regain tissue resilience.

It is also important to consider the surrounding joints such as the shoulder, wrist, and even the hips and spine. Because of the complex interconnectivity of the human body, limitations in one joint may contribute to overloading and subsequent injury elsewhere. Thus assessment and treatment of areas other than the area in question may be required for effective intervention and long-term resolution of injury. And if you’re a tennis player, it may be important to have your stroke technique analyzed by our team of experts at Ace Sports Clinic to identify areas that may be contributing to injury.

Come visit us and experience the Ace difference!

Dr. Keenan O’Young is a Canadian trained Chiropractor, former national- and international- level tennis player, and tennis coach. As a chiropractor, Keenan’s mission is to provide the highest caliber of evidence-based manual therapy and rehabilitation in order to help his patients optimize movement, prevent injury, and relieve pain. His intention is to set a new standard of Chiropractic that is at the cutting edge of musculoskeletal health and sports injuries. Keenan’s treatment style is based on a combination of soft tissue work, exercise prescription, joint mobilization and manipulation, and acupuncture. He takes a holistic approach to healthcare and is passionate about positively influencing others.

Types of Injuries we treat at Ace Sports Clinic

 We are often asked: “What types of injuries do you treat at Ace Sports Clinic?”

While back pain, neck and shoulder pain, tendonitis and muscle strains are common, we also assist with the rehabilitation of traumatic sporting injuries.

Like the one sustained by one of our clients Neil, while Heli-skiing off-piste recently in British Columbia.

Neil sustained a fractured clavicle that required surgical repair and stabilization.

 

2 days later – Neil visited Ace Sports Clinic to start some gentle massage which helped him cease pain medication

3 days later – Neil commenced some gentle restorative Yoga aimed at keeping other regions of his body moving

6 days later – Neil returned to his regular spin class using only his right arm for support

16 days later – Neil started singles squash lessons with a pro

A positive mindset, good treatment and advice has allowed Neil to resume his active lifestyle with some modifications.  He will review with his surgeon soon and is already planning his next Heli-skiing trip once his clavicle is 100% healed.  He works daily on his exercises prescribed by our Physiotherapist.

Neil has inspired us all at Ace Sports Clinic and shown the resilience of the human body.  We are honored to have played a part in Neil’s recovery.

Come visit us today and let one of our experts help you ‘live well and keep playing’, whatever your sport may be.

www.acesportsclinic.com