Iliotibial Band Syndrome and How Physiotherapy and Sports Rehabilitation Can Help

As the good weather approaches, so too does the athletic season and a plethora of triathlon events begin to take place. Recent physiotherapy and sports rehabilitation news articles have focused on triathlon and overuse injuries and where on the triathlon course those injuries occur and iliotibial band (ITB) injuries are a common injury, but exactly what do they entail and how are they treated?

Iliotibial band syndrome is accredited to being one of the leading causes of lateral knee pain in athletes, in particular with runners. Running from the pelvis and down the outside of the thigh, and inserting below the knee on the outer aspect, the iliotibial band, or ITB, works in conjunction with the other muscles of the hip to extend, abduct and rotate the hip outwards, and it also works to stabilise the outside of the knee through extension and flexiom. Therefore, it is used continually when walking and running.

Some of the training habits that can contribute towards iliotibial band injuries include; consistently running on banked surfaces. This causes the downhill-positioned leg to bend slightly inward. This triggers extreme stretching of the band against the femur. Excessive up-hill and downhill running (and indeed upstairs and downstairs) also have a negative effect. Inadequate warm-up and cool-down is another common contributory factor. But it’s not all running-orientated activity that can negatively contribute towards ITB problems; rowing, treading water, breaststroke and positioning the feet ‘toed-in’ to an excessive angle when cycling are all linked to the condition.

Because of their adoption of most of the above activities, triathlon athletes often encounter problems with the iliotibial band and the problem is when the band begins to rub over the thigh bone, causing pain over the knee joint; pain which might extend up the outside of the thigh, or down the outside of the shin. Athletes experience pain during activity and pain relieves when resting. The rubbing experience can occur for a number of reasons and it’s often associated with changes to the mechanisms of the hip, knee, or foot.

Treating ITB problems during the initial and acute stages can include ice packs and rest. Ongoing treatment focuses on targeted stretching, muscle strengthening and correction of biomechanical problems, such as over-pronation, in conjunction with a Derby Physiotherapy and/or Derby Sports Rehabilitation specialist. To find a reputable Derby Physiotherapist and Sports Rehabilitation specialist, look for good reviews online or ask your GP for recommendations.

How Physical Therapy Can Treat Thoracic Outlet Syndrome

Symptoms can start out somewhat vague. Pain may be felt in the neck and shoulder accompanied by tingling in the hand, particularly if a lot of time is spent at a computer. Hand and shoulder pain may worsen, while patients may begin to feel coldness in their fingers. Thoracic outlet syndrome may start out benign enough, but if left untreated, patients conditions may deteriorate to the point of decreased ability to work and participate in their day-to-day life.

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome (TOS) is a condition which symptoms include:

  • Numbness in fingers
  • Pain in shoulder, neck and arm
  • Impaired and sometimes discoloration of the extremities

TOS is caused by compression of nerves and/or blood vessels in the upper chest. The thoracic outlet(TO) refers to the exiting passage for those nerves and blood vessels out of the chest into the upper extremities. The TO is bordered by muscles, bone and other tissues and any issue that results in muscle, bone, and other tissues border the thoracic outlet. Any condition that results in swelling of these tissues can cause thoracic outlet syndrome. Thoracic outlet can be caused by poor posture, extensive computer work, weightlifting, however it must be noted that sometimes no sometimes there is no detectable cause.

How to Treat Thoracic Outlet Syndrome

  1. Posture Training: The first protocol in treating TOS is assessing postural problems in day-to-day activities, work and at rest to reset the posture as needed in order to decrease the pressure on the thoracic passage.
  2. Manual Therapy: The focus of manual therapy is increasing range of motion in the shoulder girdle and the 1/2 ribs. This will also aid in the patient’s ability to maintain the postural adjustments of the posture training.
  3. Transcutaneous Electrical Nerve Stimulation or TENS: TENS or EMS is a pain treatment modality that uses low voltage electric current which causes the local release of neurotransmitters such as serotonin which block pain signals in the brain.
  4. Kinesio Tape: In addition to the useful benefits Kinesio tape have in pain relief, swelling reduction and improvement in lymph function; Kinesio tape is also useful for helping patients maintain proper posture.
  5. Therapeutic Exercise: In order for patients to be able to maintain proper posture to relieve the pressure, they must have the strength and flexibility to do so. In addition to exercises done in a physical therapy session, home exercise programs using exercises such as thoracic extension and rowing are necessary for successfully treating thoracic outlet syndrome.

TOS is one of those diagnoses that start out more as an annoyance. However, if left untreated, it can become a source of disability and need for surgical intervention. In our computer and technology driven lifestyles, patient’s posture continue to degrade putting most patient populations at risk for developing TOS. It’s important for patients to understand that treatment is available and early intervention is key.

Physical Therapy for Weekend Warriors

The “weekend warrior” has been keeping physical therapy and chiropractic practices busy for years!

Since so many jobs revolve around sitting at a desk all day, the average working class man or woman leads a life that is way too sedentary. After 40 hours of desk sitting, plus another 10 hours of car, bus or train sitting, isn’t it smart to get out and play as much sports as we can on the weekend?

Not so fast.

Humans were designed to run, jump and play – yes, but we were not designed to go from completely inactive mode to professional sports hero mode in an instant.

Exercise intensity must be increased gradually in order to avoid injury. This is especially true for those of us who are not in tip-top shape.

If you sit all week and then attempt to run all weekend – plan for injury. Common injuries include joint inflammation, muscle tears, and ligament sprains. Most injuries can be treated with physical therapy after the acute symptoms have subsided, but you will likely be side-lined for a couple of weeks or more.

Weekend Warriors – Do’s and Dont’s

Weekend warriors must be realistic. Don’t expect your body to adapt right away to intense activities after being inactive all week. If you haven’t exercised in a while get some professional help. Talk to your doctor, personal trainer or physical therapist before an injury.

Warm up and Cool Down

A warm up is a simple, yet commonly bypassed way to avoid injuries. March in place or jog for eight to ten minutes to warm up your body. Then follow with some light stretching to prepare your body for progressive exercise and minimize injuries. Continuing warming up with progressive intensity.

When you’re finished with your activity, cool down. Reduce your workout intensity until your breathing becomes normalized, then finish with a repeat of the light stretching. A cool down period helps restore normal blood flow, oxygen and reduce injuries.

Plan Ahead

Being realistic and planning ahead is important. For best results, get some regular exercise every day. This allows your body to adapt and prepare for your favorite weekend activities.

If you have already become a victim of the dreadful “weekend warrior syndrome” here are a few ways that a physical therapist can help:

Assessment of Your Body Mechanics/Movements – Identifying how your body functions with regular activities is an important first step in recovering from and preventing injury.

Home Exercise Programs – Once pain is under control a proper home exercise program can begin, that will be designed to be progressive over time.

Physical therapy techniques – Physical therapy techniques include stretching, strengthening, joint mobilization, hot and cold packs, ultrasound, massage, and much more to deal with different types of injuries.

Regardless of your current state of health, age or activity level, physical therapy can you to prevent injuries and recover quickly if you have already pushed your body too far. Call or consult your physical therapist today.

What to Expect for Your First Chiropractic Appointment

Chiropractors are masters of relieving back pain. They know every vertebrae of your spine and how the back functions to adjust and relieve pain. Some people think about their first visit to the Chiropractor, believing they will experience pain. This is not the case. Here is what to expect for your first chiropractic appointment.

It is difficult to say exactly what kind of treatment you will receive at your visit. This is because the practice of chiropractic adjustments is large and varied. Each chiropractor has their own preference for the science used.

Because there are so many ways to treat, it is perfectly fine to ask questions throughout your visit to best understand the basic concept. Some things might seem odd, like a device with a handle and a rubber tip that the chiro clicks on your back to adjust vertebrae. Asking about the device and what it does is completely acceptable.

Before you make it into the exam room, you will be given paperwork to fill out that gives your medical history. The chiro will want to know information about family medical history and preexisting medical conditions. They also want to know your health provider, along with what exact pain and symptoms you are having.

They will ask when and how the pain started and where it is. They will also want to know what the pain feels like, meaning is it throbbing, burning, dull, sharp, continual, or coming and going. They also want to know if the pain is a result of an injury, such as a car accident, and what activities make it better or worse.

Once the paperwork is over, you will be able to go into the exam room. Either a healthcare assistant or the chiropractor will check your blood pressure, pulse, respiration, and reflexes like a normal doctor exam. The difference is you will also have to do neurological tests.

Don’t worry, these are simple. You should test your range of motion by turning and twisting your head, waist, back, and arms. Your muscle tone and strength will be looked at along with your neurological integrity.

Sometimes you will have x-rays done so the chiropractor can point out exactly what is out of line on your back and his or her plans to fix it. After a few months, you may have x-rays taken again to see the progress that has been made in your back.

The chiropractor will look at the results of these simple tests along with the forms you filled out. From there, he or she will find the diagnoses and treatment options. They will explain to you the problems in your back, what has caused it, what treatment they plan to administer, how it will help, and how long it will take to correct.

Depending on your chiropractor and if you agree with his or her diagnoses, than treatment might begin during the first visit. There are many treatments that could occur during that first visit. The joints that are out of line with various methods depending on your chiropractor’s preference is adjusted.

There is need for soft tissue healing and pain control. Tools such as traction, electrical stimulation, and an ultrasound is used to treat tissue and pain. None of these are painful. The most you will feel is a slight tingling sensation.

The chiropractor may draft an exercise plan to strengthen or stretch your muscles to improve balance, strength, and co-ordination. They will also recommend posture exercises, education on motor control or nutrition, and tips to cut anxiety which causes misalignment in joints.

Find a Good Physical Therapy Center for Treatment

One of the biggest challenges you face after having surgery or some other type of treatment after suffering from a musculoskeletal injury is recovery. While it may seem like the best thing to do to get relief and get better is to rest and allow your body to sort things out on its own, you need to realize that physical therapy can help you get better. Even though you have received treatment that is designed to fix the problem, you still need to work your joints out to prevent them from losing their strength, memory, and resiliency.

Regardless of how long you have been dealing with your condition, the best thing for you to do is to go to a spine center where they have the best spine specialists on staff. There you will be able to complete your recovery by seeing therapists, counselor and other professionals that can help lessen the strain and emotional stress of what you may be going through. They can provide you with a treatment plan that will allow your body to heal in the best manner possible. The best part is, they will hold your hand and guide you every step of the way to ensure that you are able to complete your treatment plan to get the best results.

Even though you may not be ready to start physical therapy, there is no reason for you to put things off. After all, you want to be able to move in as freely as possible without having to experience any pain and discomfort. Initially when you start physical therapy, you may feel some pain and discomfort. Even though you may be tempted to stop, you need to remember that what you are experiencing is very common and expected at this point in your treatment. You are learning how to use, move and recondition muscles that haven’t been used in a while.

Regardless of how you sustained your injuries, it is important to remember that recovery is not always going to be the fastest or the most comfortable to endure. That is why you need to find a good rehab center to go too. You need a place that has the best professionals on staff to provide you with the best care and support you need to make it through this situation.

In addition to finding a good spine specialist and physical therapist, you need to let your friends and family provide help you during this time. Even though you may be ready to do things on your own, it is important that you follow your therapist’s orders thoroughly. Your friends and family can offer you a great deal of support during this time. They can help to keep you motivated and in a good state of mind. They will encourage you even when you feel that you can’t go on. Before long, all of your hard work from physical therapy will pay off and you will be able to move as normal as possible without any discomfort again.

Exercise and Rehabilitation, and Rehabilitative Exercise

Generally speaking, the more fit our bodies are, the less prone to injury we will be. Now, this depends on a lot of different factors, and given those factors, also affects recovery and rehabilitation after an injury.

Height and Weight Ratio

Depending on your height, your weight can indicate that you are underweight, of average weight, overweight, obese, or morbidly obese. There are many health issues that can compound the matter of weight, but the bottom line from a musculoskeletal standpoint is that an overweight body puts extra pressure on our joints and can cause cartilage to wear away much faster as we age. Cartilage is important because it helps cushion our joints (especially in the knees) and the vertebrae in the spine. Extra strain on the joints as well as the muscles can inhibit movement and increase the likelihood of osteoarthritis.

Keeping active is essential to maintaining a strong musculoskeletal structure (including proper bone density).

NOTE: The reason people say that muscle weighs more than fat is because muscle is more dense. If an increase in muscle mass corresponds with a decrease in body fat, you could very well see your weight go up, even if you’re in better shape.


We cannot stress enough how important flexibility is to the body. You don’t have to be a yogi or a contortionist, but keeping your body flexible decreases your chance of injury and can increase speed of recovery. Your muscles, tendons, ligaments, and ultimately your skeleton all need to move with you, not fight your movement. This is within reason, of course. If you’ve never done a backbend in your life, doing one on a whim will likely cause both pain and injury. Baby steps.

Strong ligaments can mitigate the effects of sprains as well.

Muscles and Bone Density

In some cases, swimmers who rarely did workouts outside of the water developed arthritis at a very young age. Swimming is a very low impact (if no impact) physical activity, and while it is truly one of the best forms of exercise you can do, it should not be the only one. In fact, swimming is a great rehabilitative activity because of its low-impact nature.

Bottom line… there needs to be a balance in your physical activity. You do not have the full effects of gravity when swimming. As a result, those who spend a disproportionate amount of time in the water do not develop the bone density that will help their joints weather normal wear and tear (or athletic strain).

At the other end, there are high-impact exercises that cause unnecessary strain on your joints. This is why many will tell you not to run downhill, take a high-impact aerobics class, or run stairs. Sometimes, it’s just a matter of using proper technique. CrossFit has come under fire because most gyms seem to stress intensity over form. The result? Avoidable injuries. (So if you are a CrossFit aficionado, definitely do your homework on your gym and trainer).

Exercise and Rehabilitation

Exercise in a controlled, gradual, and progressive manner is the only way we can tell our body to heal. Too much too soon will exacerbate the problem and may cause more damage than the original injury.

Injections, medications, and other passive therapies can be important in providing pain relief, but they cannot stimulate the healing process. The natural stimulus for the healing process is active exercise, movement. Active exercise means we use our nervous system to tell the muscles what to do, and it requires dedication to an appropriate, comprehensive exercise and rehabilitation program. One cannot come without the other.

Injuries can occur no matter how fit we are, but the process of rehabilitation, of healing, follows the same process. We make progress at different rates because we are all different… we have different fitness levels, body types, bone densities, and degrees of flexibility. What we do know is that the body needs to be lead to heal itself.

Conditions That Restrict Mobility

One thing that shows you are alive is your ability to move. Your body needs to move in order for you to perform certain activities. When you go to work, you need to walk. When you write, you need to move your hands. When you drop something, you need to bend and pick it up. All these things need movements, big or small. However, there are certain medical conditions that can restrict the mobility of a person. Below are some examples.

The first one in the list is cerebral palsy. This is a condition that mainly affects the part of the brain that is responsible for muscle coordination. This disease is normally congenital. This means that it occurs in the prenatal stage even before the baby is born. In some cases, it can manifest during the early days or weeks of an infant. The main cause of cerebral palsy is incorrect development. When the brain does not develop the way it should be, the condition may arise. Another reason is brain damage caused by accidents and trauma. Although cerebral palsy is incurable, it is incommunicable. It cannot be transferred to other people.

The second one in the list is Spina Bifida. This condition is mainly characterized by the incomplete development of the body specifically in the areas of the brain and the spinal cord. Doctors can usually tell the existence of the condition as soon as the baby is born. Patients with this condition usually have openings along their spine area that shows the incomplete development. Since the spine is mainly affected, it can lead to partial to full paralysis. It mainly targets the lower area of the body causing the patients to have restricted mobility in their lower limbs. This condition is incurable. However, the spine can be corrected through surgery depending on the situation. Patients need some equipment to help them move such as crutches and wheelchairs.

The third one in the list is muscular dystrophy. This is a condition that mainly affects the skeletal and muscular systems. Since these two systems are mainly affected, the movements of the body will also be affected and restricted. This disease is genetic. However, it may not manifest soon. Some are diagnosed earlier during their childhood years while others are diagnosed during their later years in life. The best cure for muscular dystrophy is orthopaedic measure. It can both involve surgery and physical therapy.

The last one in the list is heart defect. When the heart is weak and damaged, there will be a restriction in mobility. The patient will not be able to run as fast as an average person can because the heart is not in a good condition to pump great amounts of blood to different parts of the body during vigorous physical exercises.

These are just some of the conditions that restrict mobility.

The Route to Happiness Through Therapy

Studies have shown that people who feel that are realising their ambitions are the happiest. Contrary to the popular belief that money equals happiness, these individuals are unlikely to be earning the highest salary or living a glamourous celebrity life. Instead they are working hard to fulfil their goals, whilst taking time to engage with others and make a difference.

If we identify what we would like to achieve, we are better able to identify ways in which we can work towards that goal. Our dream could be anything, but in order to gain the desired sense of fulfilment, it needs to be achievable. You may wish to write a book, to scale a mountain, to start up our own business, to perform on stage, to get offered a particular job or to travel. With focus, patience and commitment, these goals can be realised.

Short and Medium Term Actions

To make dreams reality, we have to be willing to take action. This usually involves stepping out of your usual routine and therefore involves an element of change. Change can be a challenge for many people and it comes with a degree of risk, however, you will need to embrace change in order to make things happen.

Few goals can be achieved in one giant leap. It is usually advisable to break down what you need to do into smaller steps. Start by planning one thing that you could do each week for the next three months that will move you in the right direction. These are your short term goals. Writing them down and ticking them off as you go can give you focus and a sense of achievement.

Medium term goals are things that you need to commit to in the coming year. These could include signing up and attending a course that will help you to develop new skills and accreditation, attending conferences or other relevant events and building a network of people that could support you in achieving your goal. In the medium term, you can also create a new list of short and medium term goals that will move you even closer to your target.

Recognising Barriers

Every one of us faces internal and external barriers that can hold us back. These could be voices of doubt in your head and uncertainty caused by past experiences. It could be pressure from others who may feel that they are trying to help and protect you, but instead encourage fear, guilt and other emotions to stir in your mind.

If these negative factors are unchallenged they can be strong enough to prevent us from reaching our potential and living the life we want to lead. They can hold us back from being the person we want to become. However, if we recognise and acknowledge these barriers and take action to overcome them we can continue on our journey to fulfilment.

It can be difficult to challenge these barriers alone, so it is advisable to seek external support. Cognitive Behavioural Therapy is a tried and tested process that can challenge the factors that are holding us back. In a confidential environment, with a professional counsellor, it is possible to face your fears and find a way forward.

If you are looking for cognitive behavioural therapy, Amersham based Cognisant Personal Development and Training can help you follow the path towards a content and happy future, where you achieve your goals.

Can You Prevent Lactic Acid From Building Up?

When you exercise, your muscles consume a lot of energy and sometimes, the energy that they have for the moment is not enough. As a result, the body releases acid to help the muscles survive the physical activity longer. However, when lactic acid starts to build up in the muscles, the effects become negative. Instead of energy, the build-up brings pain and discomfort in the affected area. You may be wondering how to prevent lactic acid from building up. Read below for some useful tips.

Drink a lot of water. If you do not want lactic acid to build up, you need to dilute the amount and dissolve it. The best thing that you can do is to prevent yourself from becoming dehydrated. When you are exercising and you feel thirsty, you need to drink water immediately. It is advisable to drink water before, during and after every workout session.

Exercise regularly. If you exercise regularly, your muscles will become stronger. They will build greater endurance and they will last longer. This means that your body does not need to burn too much sugar and does not need to consume too much energy from stored sources. As a result, lactic acid will be less likely to be released and a build-up will less likely happen.

Make your workout session today more intense than the previous one. This is a general rule when exercising. You need to increase the level of intensity of your exercises from time to time. This will make your muscles a lot stronger than before. As mentioned in the previous paragraph, the stronger your muscles are, the less glucose your body will need to consume.

Take a rest when burning starts. You will immediately feel it when lactic acid starts to build up in our muscles. You will feel a burning sensation and discomfort. When this happens, you can do two things. First, you can make your workout less intense to allow the muscles to rest. Second, you can stop from exercising for several minutes until your muscles have recovered from the loss of glucose. Make sure you take deep breaths during the resting period in order for the lactic acid to be released.

Perform cool-down exercise after your workout. The best one is stretching. Lactic acid stays in your muscles for roughly 30 minutes. By stretching the muscles, the lactic acid can be released and the build-up can be prevented. This will extremely help in preventing sore muscles from happening after the workout.

Live a healthy and active life. This acid can be prevented if you are always on the move because your muscles become strong. A healthy life, on the other hand, will release the lactic acid that has been building up and prevent damage from occurring.

These are some ways on how you can prevent lactic acid from building up.

Car Accident Treatment and Safety

Concerned about Car Accident Treatment Safety?

I had a new patient recently who was being seen by another chiropractor. My new patient reported that she was having some neck pain and headaches that just wouldn’t go away, and she wanted to know why she was in more pain following her adjustments and car accident treatment.

Severe Car Accident

It turns how that she was involved in a pretty severe roll over accident where the car rolled 4-5 times. She was taken by ambulance to the emergency room where they discovered on a CAT scan that she may have a neck fracture. When I learned this information, I asked my new patient whether or not the other chiropractor had obtained the medical records from the emergency room – especially the CAT scans. She replied that he said he hadn’t received them yet.

I was very concerned that perhaps the reason she wasn’t getting better with chiropractic adjustments is because there might be something on the CAT scan which shows a serious injury.

The Results

Well, today, just 1 day after having this new patient, I have received the CT scan results. The radiologist indicates there is possibly a fracture. And to think she has been undergoing spinal manipulation and other therapy for her car accident!

I get asked all the time whether or not spinal manipulation, or chiropractic adjustments are safe following a car accident. The answer is a resounding yes! So long as the chiropractor performs a complete and thorough evaluation and obtains all diagnostic testing previously performed as was not done in this case.

My primary job as a doctor who takes care of people who are injured in car accidents is to first and foremost arrive at an accurate diagnosis. With that diagnosis I can put together a treatment plan which will be both effective and cost-effective. Without all of the information including diagnostic testing, it is almost impossible.

What are we doing now with my new patient?

My patient will be sent for an immediate MRI followed by a neurosurgical consultation to get a clearance to ensure that treatment conservatively in this patient is safe and will be effective. Sure, it will take several days to get that done and a short delay in her treatment program, however how much better is it to be safe than sorry?

If you have been involved in an automobile accident and are not getting better, perhaps you need a second opinion. Call the office at 801-733-8300 and schedule your no cost second opinion consultation.