Headache Treatment and Dry Needling

Headache Treatment and Dry Needling

One of the most common conditions we treat within our clinic using dry needling is headaches. There are many forms that range from tension headaches to chronic headaches to migraines. With the majority of headaches, including the various types of migraines, the musculature of the upper neck and back of the head is commonly involved and much of the time can even be the cause. If you are looking for headache treatments that work we offer a few options below. 

Headache Treatment Options

Female business woman holding her head

Chiropractic adjustment is an extremely powerful tool, especially in the upper cervical region. In fact, there are entire techniques and disciplines within chiropractic care that are built around the careful manipulation of this region. Restriction of these upper cervical joints will cause further spasm of the muscles and due to their proximity to the brainstem and cranial nerves can cause many of the nerves of the head and neck to become irritated and even entrapped. 

Adjusting this region to clear out the restriction of these joints is always the first step. Due to the severity and chronicity of the headaches, the musculature of this region may still be very hypertonic and irritated and thus, it is also important to address it individually. Dry needling is hands down the most powerful way to affect the musculature in this region. 

What is Dry Needling?

Dry needling utilizes a very thin metal filament without any injectable compound to penetrate a spastic muscle or trigger point in hopes of downregulating its tone. The needle is inserted into the skin, deep down into the inflamed area. This direct and profound stimulus is such a jolt to the mechanoreceptor that it can cause a hard reset of the entire control panel that is regulating its tone. This allows for a local relaxation of the tissue and thus the resolution of the painful trigger points. 

How is Dry Needling Administered

female patient receiving dry needling treatments

There are multiple different approaches to dry needling that vary strictly around the application. The type of application that we utilize at Knoxville Spine and Sports is the ‘Set it, and leave it’ approach. Patients with chronic headaches have the dry needles are inserted in the suboccipital region, a very thin filament is used to puncture the individual muscle in question. This is commonly a suboccipital muscle, levator scapulae insertion, or upper trap insertion. 

Most people are only vaguely aware of the needle going in and once it is in the muscle will hardly be aware of it at all. These needles will be left in from 3-5 minutes and moving or engaging that muscle is discouraged during this time. 

Why You Should See A Headache Doctor

Headaches are very complex disorders indeed with multiple layers. Therefore, it makes sense that to address them, you need a multifaceted approach. Address the joint mechanics by adjusting the area and treat the residual musculoskeletal dysfunction with the most effective trigger point therapy on the market, dry needling. This one-two punch is sure to help your symptoms. Call Today to schedule an appointment with our specialist at (865) 337-5574

Physical Therapy vs. Chiropractic: What’s the difference?

Physical Therapy vs. Chiropractic: What’s the difference?

Chiropractic or physical therapy… that is the question. And frankly, a good one when you get right down to it. The faces of both professions have continued to grow and develop over the years, largely, both for the good. However, the distinct lines demarcating the lanes of each profession have begun to blur over as of late. Is this a good thing or a bad thing? Well, that depends on who you ask.

What is Chiropractic?

chiropractor adjusting a female patient upper back

Chiropractic care is likely the most dynamically different between the two as they have, generally speaking, diversified the most within the profession. Similar to how medical doctors perform a variety of different roles from general medicine to plastic surgery to research, the styles of chiropractic also drastically vary. Both the best and worst thing about the chiropractic profession is the freedom that you are granted to practice how you would like. This is great for a provider with a unique niche in mind though it winds up being terribly confusing for the general public.

 When seeing the chiropractor, you don’t know if you will be manually adjusted, adjusted with a clicking tool (an activator or integrator), or with an elaborate machine. Will the whole body be worked on or just the upper neck? Would you see the doctor for 2 minutes or 2 hours? Would you be treated on the 1st or 4th visit? Will you be asked to hold crystals and sign up for an expensive and elaborate care plan? the list goes on. However, the same principle stands for all of chiropractic care, some type of adjustment or manipulation to the spine is performed in hopes of restoring function to the body and thus making the person better in some way. Unfortunately, that is about as clear and concise as it gets when defining chiropractic. No wonder people can’t make up their minds how they feel about the profession.

What is Physical Therapy?

physical therapist in discussion with a senior female patient

Physical therapy certainly has its differences within the profession as well but, generally, people usually have a pretty good idea what they’re getting themselves into when starting physical therapy. There will likely be some forms of exercise and/or stretching specific to the injury that they are attempting to overcome. It will likely be slightly more regionally focused (specific body region) than globally-focused as in traditional chiropractic. 

What Treatment Option is Best For Me?  

Man with shoulder pain and stiff neck sees chiropractor in knoxville for treatment

So, the most important thing to consider when attempting to find out what is best for helping your condition is to find out what type of doctor you are seeing. Some people claim that upper cervical chiropractic care can help with a lumbar disc bulge, but it is fairly few and far between that they are successful. A manual chiropractor or PT is probably best for that sort of thing. However, for headaches it may be a great idea. Or, if you are immediately post-op from surgery, PT is definitely going to be the place to start looking over almost all types of chiropractic care.  

It gets a little more complicated when attempting to figure who to see between a sports chiropractor and a manually focused physical therapist for general aches and pains. “Manual focused” means that the therapist will be doing hands-on soft tissue and low-grade joint mobilizations in addition to prescribing and overseeing stretches and exercises. There is a ton of overlap between the therapies that both professions provide. 

woman receiving a sports massage on her upper back

A sports chiropractor will typically favor the manual modalities before overseeing exercises and stabilization drills. They tend to spend a little more time assessing the joints and emphasizing the manipulation of fixed or restricted regions before moving on to the stability and strength phase of care. It’s important to note that this doesn’t just mean mobilizing joints. Soft tissue treatment via a number of therapies, ART, Graston, cupping, etc. are employed within the sports chiropractic realm.

Drawbacks to Be Aware of

A fairly considerable drawback is that many of the insurance companies don’t reimburse chiropractors for performing the necessary amount of exercise, strength, and stabilization work that is needed to adequately rehabilitate an injury. However, they will reimburse physical therapists fully for that same strength and stability phase of care. Thus, due to the restrictions placed on chiropractors with regard to reimbursements, the ratio tends to be 60-65% manual therapy and 35-40% therapeutic exercises. This tends to be the inverse for physical therapy. 

So, What Does This Mean for Me?

 The general flow of care for both sports chiropractic as well as PT is as follows:

  • Maximize mobility of the restricted or damaged tissue, joint or otherwise, and emphasize means to maximize tissue health.
  •  Stabilize and strengthen the now mobile joint through therapeutic exercise specific to that region.
  •  Increase motor control of the region through various proprioceptive challenges such as balance work and larger scale functional movements.

chiropractor adjusting a male patient lower back

Therefore, a loose strategy to follow, that of course varies depending on the condition, would lean towards seeing a chiropractor on the front end of the injury since they tend to focus slightly more on the number 1 listed above. For numbers 2 and 3, perhaps consider transitioning into physical therapy once improvements to the joints and tissues have been made since they will be able to spend the time needed to maximize stabilization and strength of specific regions. 

Unfortunately, it’s not a hard and fast science when deciding between sports chiros and physical therapists. But one thing stands, therapists (PT’s or chiros) that have respect for the other profession and are willing to refer back and forth will always achieve the best outcomes and get you better quicker.


How Can Sports Chiropractic help an Athlete

How Can Sports Chiropractic help an Athlete

There is a reason that nearly every professional sports team employs a chiropractor. Tom Brady, who is nearly 40 and just as sharp as ever has been known to talk about his relationship with chiropractic by saying, “As long as I see the Chiropractor, I feel like I’m one step ahead of the game”. In fact, all of the NFL teams and indeed many of the D1 collegiate teams have chiropractors on staff that work alongside the athletic trainers to ensure that their athletes are functioning at their fullest capacity.

 So what is it that makes chiropractic care so important to Athletes? There are a few important things to note first about human physiology to fully understand how chiro can have such a profound impact on performance.

Common Causes of Injury

Chiropractor adjusting a patients lower back

There are many reasons that joints may become stuck or restricted. Much of the time the problem is postural in nature, meaning that the way that you sit, stand, walk, etc. can put certain joints at a biomechanical disadvantage. Having these joints in improper positions for long periods of time causes the tissue around them to tighten up and bind down the joint. However, in the Athletic fields, it largely has to do with the joints constantly absorbing impact. This can be seen in the constant ground reactive forces being placed on runners, the collisions of football, the unilateral swings of tennis, are all common sports injuries that require continually pulling on muscles and joints are absorbing forces.

These joint restrictions can happen all over the body from the head to the toes. Chiropractors are known by the public primarily as back doctors but careful manipulation of places like the feet, hands, and shoulders can be just as impactful especially to the athlete.

How Our Bodies Pain Receptors Work

Tennis player holding his elbow due to pain

As Humans, we derive almost all of the information about where our limbs are in space from little pain receptors in the joint. The same way that a digital thermometer can give a readout immediately as the temperature changes, our joint mechanoreceptors do the same thing with movement. They give constant feedback to the brain that lets us know exactly how our feet, hands elbow, and indeed everything, is moving.

 When joints are restricted and are unable to move to their full capacity we lose our innate ability to perceive where our bodies are and how they are functioning in space. It’s like a thermometer that will only tell you the temperature between 50 and 70 degrees. Outside of that range, it’s useless and we no longer know how to prepare for the elements. It is much the same way with our joints. When our brain no longer knows fully how that joint is moving, it can’t recruit the proper muscle to stabilize the joint. 

This is when we see things like non-contact ankle sprains, ACL tears, and even craziness like rupturing a disc from a sneeze! When the brain can’t fire the right tissue to stabilize the joint against the movement, we pay for it in a big way.

illustration of the nerves in the human shoulder

This same concept can be extrapolated upon by looking at athletes returning from a mild ankle sprain. Trauma to the tissue will cause inflammation which leads to two separate ways that the body will try to stabilize the injured area, muscle spasm, and adhesions in the tissue. During the acute stage, these two mechanisms are important so that we don’t make the injury worse, however, they both will lead to the original topic of conversations, restricted joints. As stated above, this will change the neuromuscular control from the brain which, if not treated, leads us back to an increased likelihood of undergoing another ankle sprain due to a lack of motor control. 

Knoxville Sports Chiropractic Treatment

chiropractor helping patient stretch his shoulder

As Sports chiropractic proffesionals we address these restrictions head to toe. The chiropractic adjustment is one of the most important tools available for freeing up restricted joints which we utilize as the cornerstone of our practice. From there we use cutting edge tools and techniques for treating the soft tissue that ranges from Active release technique, Graston, dry-needling, cupping, and a plethora of other modalities to ensure that the adhesions and tight, spastic musculature are fully returned to its pre-injury state. 

From there, neuromuscular re-education through a series of therapeutic, functional exercises are absolutely imperative to ensure that you are once again able to move the way that you did before, and further, to decrease the likelihood of reinjuring yourself. The best part of all of this, you don’t need to be an athlete to benefit from this type of care. If you move, you need it!

Ankle Sprains and how to treat this condition from home

Treating Ankle Sprains from Home

A quick search on the internet for most common ankle sprains will show that roughly 75% of all ankle sprains are what is referred to as “Inversion” ankle sprains.  This injury occurs due to excessive rolling of the foot and ankle to the outside of the foot. Inversion is the foot position you would be in if you were to walk on the outside of your foot.  Eversion is the opposite foot position and eversion ankle sprains occur less often and will not be apart of this particular blog post; however, this might be a good topic for us to discuss another day.  

What Causes an Ankle Sprain

Almost all ankle sprains are due to an excessive force to the ankle applied in this extreme inverted foot position.  Most ankle injuries are sustained due to several factors which may include ballistic sports activities, walking or running on uneven surfaces, prior ankle injuries, improper shoe wear, and poor physical condition.   Ballistic sports are characterized as any sport needing quickness, explosive movements, and agility. With these quick explosive movements, the ground reactive forces applied to the foot and ankle are such that the ligaments of the foot and ankle may be overloaded or overstretched causing foot and ankle injury.

If you have ever walked on cobble stone streets in Savannah, Georgia you can testify to the negative effects of walking or running on uneven surfaces.  When I think of these type of surfaces, “trail running” comes to mind as well as playing on poor field quality with clumpy lumpy grasses. I can remember playing college soccer on uneven fields, thinking about each grassy clump as a land mine just waiting for some poor soccer player to come along and set it off.  It does not take much imagination to consider how uneven surfaces can negatively affect the foot and ankle.

Ankle Sprain Treatment in Knoxville

Within Knoxville Spine and Sports, we have treated many runners and athletes over the years for inversion ankle sprains and we have noticed many have had prior ankle sprains leading to loose ligament that predispose them to repeated sprain of the foot and ankle.  Every time we sprain a ligament or joint capsule, we deform those structures and make those joints looser. I can remember the first time I dislocated my right shoulder (playing baseball no less, #DontJudgeME) the pain was nauseating to say the least and yet each right shoulder dislocation I had was less and less painful and quite easy the next time around.

As a Sports Physician, I find myself walking around town watching other peoples gait and thinking to myself how poor their shoe wear is and what a difference good shoe wear would be to help restore the proper biomechanics of walking and running. This is a unique time in the life of footwear as now more than ever it is both at its best and worst. I am constantly assessing patients shoe wear for durability, stability, and motion control.  I could write an entire blog just on the necessity for good shoe wear to help maintain proper foot and ankle control while playing sports or walking down the street for that matter. Needless to say, footwear is crazy important when talking about inversion ankle sprains.

To this point, I can’t tell you how many times we have heard a patient say they were walking down the street or in the house and sprained their ankle.  Some of this is due to lack of physical condition or what we consider deconditioning due to lack of physical activity. I am thinking of the dad who is a desk jockey and wants to go outside and show his children that “Dad still has skills” and ends up with a grade II inversion ankle sprain.  This happens all the time!

How Our Chiropractors Grade Sprains to Assess Treatment of Sprained Ankles

Sprains are graded as I, II, III and are treated differently depending on the severity and number of structures involved.  A sprain is defined as a violent overstretching or tearing of a ligament or joint capsule. These sprains cause damage to the affected structures and sprains are graded based on severity of the damage and the number of structures involved.  We will briefly describe each grade and the clinical signs and symptoms of each.

Grade I:

Grade I Inversion ankle sprains are described as an overstretch of the affected structures having minimal swelling in and around the outside of the ankle joint as well as mild to moderate pain and tenderness with touching the affected area.  There will also be a 25% loss of ankle mobility due to pain and swelling. The foot and ankle in question will not tolerate fast walking and will exhibit pain with single leg toe raises and light single leg hopping.

The course of treatment will be to P.R.I.C.E. (protect, rest, ice, compress, elevate) the ankle for the first 48-72 hours.  There must be no pain with walking, or a brace or crutches will be needed in order to accomplish pain free ambulation/waking.  You must not walk on the affected foot until there is little to no pain with weightbearing. Mobility is key so after the first 48 hours and within a pain free range one should begin ankle mobility exercises such as using the toes on the affected foot to draw the alphabet in the air.  Sometimes we will ask the patients to write their name in cursive with the toes of the affected foot. This promotes increased healing with a full and free range of motion. Once you are able to weight bare pain free you must then start to strengthen the ankle and work on your balance.  Balance is the fastest and quickest way to rehab an ankle injury. These exercises should be safe yet challenging to the affected foot and ankle.

Grade II:

Grade II Inversion ankle sprains are described as having multiple ligaments involved with possible partial micro-tearing and moderate to severe pain with single leg toe raises.  Swelling will be pitting and full on the affected outside of the foot and may continue to the front and back side of the ankle. The foot and ankle will not be able to tolerate weightbearing nor single leg hopping.  Pain will be 4-8/10 on the pain scale and there will be a 50-70% loss of active mobility in the ankle joint. There will also be bruising around the outside of the ankle and foot over the course of the first 72 hours following the injury.  

The course of treatment for the first 72 hours will be the same as for a Grade I (P.R.I.C.E).  It is imperative that you be able to offload the foot and ankle with crutches or a walking boot until you are able to weight bare without pain.  This may take up to 2 weeks and then an additional 7-10 days in a stabilizing ankle brace. With a Grade II ankle sprain it is my professional opinion that seeking the help of a trained sports medicine specialist is appropriate to assess and speed up the healing process with the most effective means possible.  

A functional rehabilitative program will be needed for the patient to return to sport in a safe and supported way.  The Home Program will start with controlling pain and the inflammatory process, improve pain free range of motion and a range of motion that is freely accessible.  The next phase of Home care will be to increase balance work and strength of the affected joint.

Grade III:

Grade III Inversion ankle sprains are described as a complete tear of the ligament in question and or the joint capsule with possible fracture of the fibula or tibia.  This is an extreme injury and will need the expertise of a trained physician and possible diagnostic imaging to see the extent of the damage.

It is necessary to seek professional help in these cases and surgery may be required.  The key is to P.R.I.C.E for the first 72 hours and maintain good pulses in the arteries of the foot and ankle.  Seek treatment within the first 72 hours so that the extent of the injury can be assessed and measured appropriately.  Rehab will be necessary at the appropriate time which may very depending on the severity of the joint and ligament damage.  

Do You Have a Sprained Ankle?

If you think you have a Sprained Ankle, call us to find out. Sprained Ankle treament in knoxville is not far away. We have highly qualified doctors to help you with non surgical and drug-free treatment of your injury. If you have any questions about this please feel free to call us and we will be happy to speak with you in depth.  

-Dr. Bert

Thawing out the frozen shoulder: Why Sports Chiropractic and Physical Therapy is LITERALLY Your Best Option

I want to lead off this conversation about frozen shoulder by saying that there are few professions that are better at treating this condition than a sports chiropractor. It is a condition that, I personally, love to treat because it showcases the tenacity and perseverance of both the doctor and patient alike.

Frozen Shoulder Treatment in Knoxville

Frozen Shoulder Treatment takes considerable mental and psychological stamina due to its frequent slow response to care. Here at Knoxville Spine and Sports, we’ve seen many athletes go through this process. The warm fuzzies that come with seeing a patient leap and bound towards symptom resolution tend to be severely delayed compared to many other shoulder conditions causing shoulder pain.

It takes a firm understanding from the patient that when they sign up for care, they are going to war and that full restoration of shoulder mobility will take considerable work on their part as well as the doctors. But when the inevitable victory comes, boy is it sweet.

The Phases of Frozen Shoulder Treatment

Frozen Shoulder and the Anatomy of the shoulder at your chiropractor in knoxvilleAdhesive capsulitis, or more commonly, frozen shoulder presents in 3 stages; the acute inflammatory stage, the stiffening stage, and months to years later the “thawing” stage. During the acute phase, the shoulder is very painful and the range of motion is severely reduced in all planes. This could be traumatic, as from blunt trauma or rotator cuff strain, or insidious, meaning that it sort of came out of nowhere.

It is not uncommon for its victim to not remember anything happening that would have provoked it. Commonly, it will hurt bad enough to affect sleep and take pain medications. Activity is typically limited as the pain keeps you from significantly moving it. This phase is probably the most important with regards to future outcomes as “learned immobility” will set you up for disaster down the line.

It is pivotal to keep pushing your shoulder to move through those painful motions as immobility will lead to an even stiffer shoulder capsule continues to fibrose through the latter stages. During the stiffening phase, the inflammation of the capsule is mostly resolved and though the shoulder is not as painful, raising the arm to the side or externally rotating it is still severely limited compared to the other arm. This phase will come anywhere from 1-3 months after the acute phase.

In the final phase, you’ll notice that the pain is pretty much gone. You may even have a slightly better range of motion as compared to the first 2 stages, but it will still be markedly reduced. Doing overhead activities will be quite difficult. Golf swings will have been altered, throwing will be difficult, and your jump shot will look a lot different. Fortunately, there is hope. But you’ve got to MOVE IT.

Sports Chiropractor in Knoxville

When you have a sports chiropractor in Knoxville, don’t let them go! Sports chiropractic is so effective because of it of its multifaceted approach to the treatment of this condition. I say this because it is a difficult condition to treat and it must be done right! Here are a few of the weapons we utilize in the war against a frozen shoulder.

Chiropractic Manipulation

Chiropractor treats frozen shoulder in knoxvilleChiropractic Care is a wildly effective strategy in the restoration of shoulder mobility specifically in the stiffening and thawing phases. With frozen shoulder, the tissue of the glenohumeral joint (shoulder joint) capsule is rigid and fibrotic. You can think of it as a brand-new pair of stiff, heavy-duty, blue jeans.

The only way to get them to loosen up is to wear them and wash them extensively. This too is the case with restoring shoulder movement. Mobilizing the shoulder joint with an adjustment puts a fast stretch on the joint capsule helping to break down some of that fibrotic tissue.

Adjusting the cervical spine, thoracic spine and other joints of the shoulder helps to bring nervous system awareness to the musculature surrounding the tissue and helps it to maintain function.

Active Release Technique and PIR stretching

These are two manual ways of stretching the joint to allow for the maximal fibrotic release of the shoulder joint tissue. Active Release Technique (ART) utilizes a combination of deep focused pressure along the muscle or joint with a specific stretch to break up as much fibrotic tissue as possible.

You can use this technique on the anterior and posterior joint capsule as well as the small stabilizing musculature of the shoulder. With this the tissue is maximally shortened, the pressure is applied over top of the tissue that you want to work, and then fully lengthened under that tension.

You can feel the adhesions slide under your finger as the tissue is moved through its range. Multiple passes here tend to be very helpful. Post-Isometric Relaxation (PIR) stretching can be used on the muscles that are inevitably spastic around the joint to coax them into submission.

Here you will contract the tissue for approximately 10 seconds or just enough time to override the mechanoreceptors in the muscle that are telling it to tighten up. Following this contraction, you will notice that you can move the area through a greater range of motion.

Dry Needling

Frozen Shoulder Treatment using dry needling in KnoxvilleDry needling is a fascinating modality, as the needles themselves are used to create a chain of events within the tissue that decrease trigger points. It is well known that myofascial adhesions and trigger points riddle the tissue around an immobile joint. With frozen shoulder, another musculature has to compensate for the decreased joint range of motion.

Commonly raising the arm will rely on shrugging the shoulder and bending the torso to get the arm up to it’s desired height. This means that the levator scapulae, upper trap, rhomboids, and neck muscles are getting far overworked.

Dry needling greatly helps to release out that tissue and decrease compensatory pain from the immobility of the shoulder joint. It will also release out the rigid deltoid and rotator muscles of the affected shoulder helping to increase the range of motion.

Visit Knoxville Spine and Sports for Frozen Shoulder Treatment

Frozen Shoulder Treatment is essential to athletes and non-athletes alike. These treatments mentioned have all been shown to increase shoulder mobility and help to restore function in a frozen shoulder. However, one the most important things that you can do will be your mobility homework.

No matter how much range we gain during a visit to the clinic, the patient MUST do their best to maintain those changes through routine stretching and end-range isometric strengthening exercises. 5 minutes of stretch and strengthening work at least 6 times a day will be pivotal to regaining mobility. With the combination of regular treatment and home exercises, the average patient will note considerable improvement within 1-3 months.

Call Knoxville Spine and Sports if you find your Shoulder Frozen

Shin Splint Treatment for Runners

Shin Splint Treatment for Runners


Finally… most of the cold, dark, rainy days (especially here in Knoxville) are behind us and we are trading out our winter coats for running gear. The early season races are now upon us and it is time to make up for lost training days during the winter months. This is always a very popular time of year for us at the office as the injuries from training too hard on tissue that is still in hibernation mode are rearing their ugly heads. I wanted to take a few minutes to address one of the most common of these injuries, Shin splints.

What Are Shin Splints?

What are shin splints knoxville treatmentShin splints hold the clinical name of medial tibial stress syndrome (MTSS). This is a fairly accurate name as the most common place that people feel leg pain is deep on the inside of the shin bone. Pain can also be felt on the very front of the leg which is differentiated as an anterior shin splint. The muscles in these different compartments when excessively stressed, often for the first time in a while, can pull on the tibia harder than it is accustomed to and cause deep aching pain. The periosteum, or outer layer of bone that tendons and ligaments attach to, is rich with pain perceiving nociceptors and are quick to transmit that pain signal. This is typically accompanied by inflammation of the muscle, tendon, or in worse cases the actual periosteum itself.

Shin Splint Pain

The pain often sets in as a dull ache that grows to a throbbing type pain in the inside or front of the leg within 10-15 minutes of exercise. Runners will often be most acutely aware of the pain when running downhill, or for any length of time on a surface that isn’t flat or uphill. It is important to be able to differentiate this pain from other conditions that can be more malicious in nature. Compartment syndrome is a similar condition and is sort of like a shin splint on steroids. Similarly, there is pressure on the bone from the muscle but primarily the pain comes from swollen muscles trapped in the small and enclosed space of the deep compartment of the leg. This can be very dangerous if left untreated as it can destroy the blood vessels and nerves that live near that deep compartment. Stress fractures of the tibia can also present just like shin splints as do some high ankle sprains. The most important thing here is to see a professional if this pain isn’t going away.

What Causes Shin Splints

What causes shin splints with image of two runners at sunsetShin splints can be caused by a number of things but the most important place to start is with foot and gait during running. Runners that strike primarily with their heel first are immediately predisposed to this condition. In order to keep your foot from smacking the ground as your heel hits the ground, the muscles of the shin must fire and eccentrically lower the foot to the ground. This puts huge stress on those muscles as well as the periosteum where they attach.

So now the question is how do we unload those muscles during the gait cycle. Commonly heel striking comes from a “reaching” type of running pattern. This means that the feet are landing far out in front of the body when you run and almost pulling you forward instead of primarily pushing off. Ideally, the foot would land as close to directly underneath the body as possible to shift the load from the rearfoot (or heel) to more of the midfoot and thus more evenly distribute the impact force of landing among all of the muscles of the leg.

How to Alleviate Shin Splint Pain

Ok Matt, got it. Land with my foot underneath my body and avoid shin splints. Easy. Hopefully, it is, but very commonly the reason that you are reaching with that front foot, to begin with, is a restriction at the hip that is shortening the stride. As you shift your weight forward in your stride to make sure to land on the proper area of your foot, the back leg (push off leg) must be able to move farther back behind you into extension. With tight hip flexors at full-blown epidemic status, it’s likely that these are certainly contributing to your lack of hip extension when running. This, in turn, is shifting your center of gravity back and causing you to have to reach with your front leg, thus landing with a mighty thud on your heel and jarring the deep muscles of the leg. The culmination of this, shin splints.

So, here’s some guidance to avoiding these buggers and hopefully staying healthy through this training season. First, ease back into training. We are amazing, adapting machines but our tissues do need time to adjust to the barrage of new stressors that we put on them once the weather is fit. Next, pay attention to the surface you are running on. If you frequently run on a sloped or cambered road, make sure that you run back on the same side so as to stress those muscles evenly on both legs.

Shin Splints and Track Running

0150415001554823961.jpgThe same thing goes for the track. Be sure to change direction halfway through your workout as always turning one direction will asymmetrically tax those structures the same way. Also, check your hip flexor extensibility. When laying on your back and you pull one knee to your chest, does the other stay on the ground with little to no movement in the low back and hips? If not, STRETCH.

Finally, be cognizant of your gait. Do you feel your feet smacking when you run downhill? Are the heels of your shoes wearing more than the forefoot? Is it hard to shift your center of mass forward to get your feet underneath you as you run? If you answered yes, let us know so that we can pinpoint the exact cause of this and get you running safely and efficiently through the rest of the season.

Shin Splint Treatment in Knoxville

If you are one of our avid runners or just feeling the pain when you run, it’s best to consult with those who work day in and day out with Shin Splint Treatment in Knoxville. Our chiropractors are highly skilled at treating athletes and non-athletes alike. All of our patients receive a free consultation. This is so we can determine what your problem is before we begin any sort of treatment by our chiropractors or physical therapists. Call or contact us today!

Happy Trails.

-Dr. Matt